Return to home page

Reservation and Information Request Form

Please use this form to inquire about reservation availability and rates. 

NOTE:  Submitting a request for information via this form is not an active reservation and you are under no obligation.  You will be personally contacted by a booking agent with a rate quote and other information.  Rooms must be guaranteed with a credit card for confirmed reservations.  Confirmed reservations must be cancelled by 6 p.m. on your arrival date or the room will be charged.  If you prefer you may call  our office directly at 417-667-3331.

Please provide the following contact information so our booking agent can provide you with an accurate rate quote.

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip
Work Phone
Home Phone
FAX
E-mail
Date Arriving
Date Departing
Number of Adults
Number of Children
Number of beds
Number of Rooms 
Discount Options

Please use this space to request or provide additional information.

 

Thank you for using our Reservation Request Form.  Please push the 
REQUEST button below only one time this may take a few seconds to process.
71 Motel Registration Form.  Copyright © 2002 71 Motel, All rights reserved.  Revised: July 05, 2002
This site created and maintained by Global Web Systems, Inc. Nevada, Mo 64772.  To contact the Webmaster click here.