Hotel Request Form

BMD Travel and Tours

Hotel/Resort Request Form

Lead/Contact Information:
Title/First Name
Last Name
Address
City	, Zip
Telephone (with area code)
FAX (with area code)
E-Mail Address(es)

Hotel/Resort Information:
Preferred Hotel/Resort (optional)
Location (i.e. City & State)
Geographical Preference	Other
Preferred Chain (optional)
Address (optional)
Category/Class
Room Type	View

Preferred Date of Travel

Travel Flexibility

Are You Flexible with your travel Dates?

If available, would you prefer an All-Inclusive hotel/resort (i.e. all food, beverages, and resort entertainment included)?	Yes No
Hotel Membership Numbers & Program Information (i.e. Hilton Honors, Starwood, etc)
Number of persons traveling:
TOTAL number of persons (incl. children & babies)
Number of children (2-11 years)
Number of infants (0 & 1 years)

Optional Flight Information:
If air reservations are needed, from which city:
Preferred Airline
Frequent Flyer #	(you may enter multiple numbers)

Preferred Time of Travel

Departure Time

Return Time

Travel Flexibility

Are You Flexible with your travel Times?

Optional Car Information:
Preferred Car Rental Company (i.e. Alamo)
Preferred Car Type
Car Membership #	(you may enter multiple numbers)
Notes/Special Requests:
Would you like to include Trip Cancellation Protection Insurance??? Yes No
Travel Agent (optional)

Hit Counter