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Custom Reservation Request Form Sample
 
Place your marina diagram which enlarges when clicked for boater's reference
 
You can add other custom text in this space as well.
This form is fully customizable. You can add, change or delete questions.
 

 

First Name * Last Name *
Guest status * Have you been a customer in the past?
Yes
No
Group Are you part of a Group?
Yes
No
Group Name If yes, what is the name of your Group?
Address *
City * State * Zip *
Phone * Fax
E-mail *
Contact me by * E-mail
Phone
Fax
Request for Please indicate one or more marina in which you have an interest.
Marina A
Marina B
Marina C
Interested in * Slip
Floating Slip
Mooring
Rack Storage
Arrival * [mm/dd/yyyy]
Departure * [mm/dd/yyyy]
Boat Name * Boat Type * Power
Sail
Length * Beam * Draft * Height
Power 30 amp
50 amp
100 amp single phase
100 amp 3-phase
200 amp 3-phase
Other
Other If "Other", please specify power requirements
Comments or
Questions
Fully customizable space available here for:
- Links for more information • Images • Marina Reservation Terms and Policies
- When the boater submits this form, a copy of it will be emailed to the marina personnel you specify to receive it. 
- The record of the form will also be available in your Control Panel for future reference and its data exportable as text.
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