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.