Administration & Forms

Affinity Inns & Resorts

New Member Application - (Form #1 of 2)

Desired Brand - (Please check one Brand below) - Please copy this form and send via Fax as shown below.

Carefree Inn: __ Arlington Suites: __ Galleria Hotel/Resort: __ Emerald Palms Resorts __

Property Name: _________________________________________________

Address: ______________________________________________________

City/State/Zip: __________________________________________________

Property Phone: _________________________________________________

Property Fax: ___________________________________________________

Entity Name: ___________________________________________________

Entity Type: ____________________________________________________

State of Registry _________________________________________________

Tax ID Number _________________________________________________

Owners Name: __________________________________________________

Address: ______________________________________________________

Phone: _______________________________________________________

City: ________________________________________________________

Fax: ________________________________________________________

State/Zip: _____________________________________________________

Cell Phone: ____________________________________________________

eMail:________________________________________________________

Owners Name - Title ______________________  _______________________

% of Ownership_______________

Other Owners :  _________________________________________________

% of Ownership  ______________

Average daily room rate for Year Ending 2013 : $_________________

Annual Occupancy for Year Ending 2013  _______________%

Corridor Type: _____ Interior _____ Exterior _____ Other ____________

# of Floors _______ # of Rooms _______ # of Closed Rooms _______

Room Types: King: ______ Doubles: ______ Singles: _____ Suites: _____

Signed: __________________________________

Title: ____________________ Date: ___________

Enclosed the application fee via credit card authorization (Master Card or Visa only) authorized by applicant.

Fax signed application & credit card authorization (below) to 1-866-205-4222. Dan Sweigert

Application Fee Schedule:

CareFree Inns :  $1,000.00

Arlington Suites : $1,500.00

Galleria Hotels & Resorts :  $2,000.00

Form #2 of 2 to submit for the Preliminary Application - Please copy, fill out & fax as shown below

Affinity Inns & Resorts

Credit Card Authorization Form to submit with the Application form above.

Once this form is filled out and signed, please fax it to 866.205.4222.

If you have any questions regarding the form, please call me at 412.638.1992.

Credit Card Number: ____________________________________________

Expiration Date: _____/_____ Security Code: _________ (3 digit)

Card Type:  Visa  MasterCard (circle one)

Cardholder Name_______________________________________________

Company_____________________________________________________

Address_______________________________________________________

City/ST/Zip____________________________________________________

Telephone_______________________

Fax________________________

Authorization to Charge Credit Card

I, ______________________________________, hereby authorize the amount of

_______________________________________

to be charged to the above credit card for 

_______________________________________________________.

Signature

Date__________ Dan Sweigert - VP of Sales & Development 

Cell: (412) 638-1992  -  Call Dan if you have any difficulty filling this out.

 eFax: (866) 205-4222

 eMail: dksweigert@aol.com

Thank You !

Contact Us     Cell: (412) 638-1992 - Call Dan if you have any difficulty filling this out.