* Indicates required fields Who would you like your department to pay for? Guest Name * Reservation Confirmation # * What would the department like to pay for? The department would like to pay for * All Room Nights Guest will provide payment at check in. If the guest fails to arrive or cancel the reservation 24 hours prior to arrival we agree to be billed a fee equal to the first night's charge Limited Number of Nights (see below) Fixed Amount If you selected "limited number of nights" or "fixed $$ amount" above - please enter it here What additional amenities does your department want to pay for if they are used by the guest? The department would like to pay for (additional amenities) Rollaway Bed ($10/night) Microwave & Refrigerator Unit ($5/night) Telephone Calls Gift Shop Purchases What PTA number would you like to use?example: 0000000 - 0 - ABCDE PTA # * Example: 0000000 - 0 - ABCDE Email Address of PTA # Owner (the owner of this PTA # will be sent a copy of this transaction) * Who is authorizing this payment? Name * Phone * Email * Department * By checking this box, I certify this expenditure conforms to all applicable policies regarding the acceptable use of the above account * Yes Comments Printer-friendly version
