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Name Address Address line 2 City State Zip Room Preference non-smoking smoking   Room Type Sm Motel Room Lg Motel Room Waterview Eff. Waterfront Eff. 1 Bedroom Apt Waterfront 1 Bedroom x Large 1 Bedroom Month of arrival jan feb march april may june july aug sept oct nov dec Day of Arrival 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Length of stay in days 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Please make a note under "special instructions" if your stay is going to be longer than 1 month.               Please be sure to fill in ALL of the information on this form so that we may process it properly! Thank you from the Pelican Cove

E-mail Address Special Instructions and Requests Best Time to reach you to confirm Reservations? day evening any Area Code Phone Number This is my Home Work phone. (please choose) Additional Phone Number: (optional) Area Code Phone Number This is my Home Work phone. (please choose)