Economy Inn
658 Elmira RD. Ithaca, NY 14850, Tel: 607 277-0370, Fax: 607 277 3618
Reservation Form
Reference: _____________________________________________________________________
Guest Name/Last Name:___________________________________________________________
Billing Address: __________________________________________________________________
City: _____________________________ State: ____________ Zip: _________________
Telephone No: ( ) ______ - __________ Fax No: ( ) ______ - _________________
Email: __________________________________________________________________________
Arrival Date: _______________ Arrival Time: _______________ Departure Date: _______________
Room Rate: $ __________ No of Nights: ________ No of Guests: ________ (Extra Person $5.00)
No of Room (s): ________________Queen Bed: ________________ Two Double Beds: _______________
Non Smoking Room: __________
Smoking Room: __________
Cardholder’s Name (if third party pay proved ID): ____________________________________________
Credit Card No: _______ - _______ - _______ - _______ Expiry Date: _________ /_____ ________
Authorization Signature: _________________________________ Date: _________________
This form serves as a credit card reservation receipt for Economy Inn. By signing this document the customer gives full authorization to Economy Inn to charge for number of rooms rented and any other phone charges that may occur to a specified credit card that will not be present at the time of check-in. A photocopy of front and back of a credit card is required, with a valid photo ID of the customer. Please attach a legible copy to this document and fax it to the number listed above in a timely manner. Guest will not be permitted to check-in without prior authorization of this document.
Cancellation Policy:
If a cancellation should become necessary, than please cancelled at latest 3 days prior to the reserved date of arrival; otherwise we shall have to charge you for the first night's stay.