The Manor Motel - Reservations Fax Page
Print this page and fax to 419-624-1219

Dates of Stay: ____/____/____ through ____/____/____

Age: _____ (must be 18 years with valid credit card)

# in Party (adults): _____ (children 12 and under) _____

Est. Time of Arrival: ________________________ a.m. p.m. (circle one)

Smoking: Yes_____ No______ Either______ (check one)

Room Type Preferred: (check one)
two double beds______
one king size bed______
one double bed_______

Room Name: _______________________________________________

Credit Card Name: __________________________________________

Credit Card Type: Mastercard_____ Visa______ (check one)

Card #: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _

Exp. Date: _____/______

Phone: (________) ________-__________

How did you hear about us?____________________________________

48 HOUR CANCELLATION NOTICE OR YOU WILL BE CHARGED THE FIRST NIGHT. IF YOUR CREDIT CARD DECLINES THE MORNING OF YOUR STAY, WE CANNOT GUARANTEE YOUR ROOM.