APPLICATION

Deposit: $300 non-refundable (goes towards your total)

Housekeeping: Mandatory once per week

Check in Date: Length of Stay: Check Out Date

Nature of stay: (Check one and provide materials)

Please provide legible copies of both the FRONT and BACK of the credit card and valid ID
CC Type: VisaMCAmex

CC #:
Expiration date:
Security code:
Card holder signature:
Card holders billing address:

Who will be responsible for your stay? (If third party is paying, please request credit card authorization form)

I , (Please print credit card holders name as it appears on credit card) authorize The Hotel Alexander to charge and bill my credit card for charges incurred by applicant.

Contact Email :
Phone Number:

Guest Names:
Check-in/Checkout dates:

Company Name:

Room Type:
Room Rate:

Credit Card Number:
Security Code:

Exp Date:

Type of credit card: AmericanExpressVisaMCDiscover

Signature of Cardholder:

Today’s Date:

Please provide legible copies of both the FRONT and BACK of the credit card and valid ID

Applicant Information:

Name:
Social Security Number:

Passport Number:
Date of Birth:

E-Mail Address:
Facebook URL:

Business Telephone:
Cellular Telephone:

Residency

Present Address:
Landlord’s Address:

City/State/Zip:
City/State/Zip

Landlord’s Name:
Landlord’s Telephone Number:

How long have you been at this address?:
Monthly Rent: $:

Previous Address: (If current is less than 2 years):

Landlord’s Name:
Landlord’s Address:

Landlord’s Telephone:

How long have you been at this address?:

Employment:

Company Name:
Company Address:

Job Description:

Supervisor’s Name:
Telephone Number:

Annual Salary: $
Length of Employment:

Additional Income: (Source):
Annual Compensation:

IN CASE OF EMERGENCY PLEASE NOTIFY:

Name:
Address:

Telephone Number:
Relationship to you:

CHECKLIST FOR APPLICATION: (Make sure you have all the required information sent to us)

ApplicationNatuCopies of GovernmentIssued Picture ID’s (Passport, Drivers License)re of Stay Documents

Signed:
Date:

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