Credit Card Form

Credit Card Type*
Name*
As Shown on Card
Credit Card Number*
Expiration Month*
Expiration Year*
CVV*
Phone Number*
Billing Address*
Arriving Guests Name(s)*
Arrival Date*
MM
DD
YYYY
Departure Date*
MM
DD
YYYY
Daily Rate $
Taxes 14.07%
Total Rate $
Incidentals $100*
- Use Existing Credit Card
- Guest will provide Credit Card
Consent*
I certify that all information is correct and accurate.
I hereby authorize UNIVERSITY INN & SUITES to collect payment as indicated in the Rate Information above by processing a charge to the credit card listed above. I understand that a new form will need to be completed if guest wishes to extend his/her stay. I certify that I am the authorized signer of the credit card listed above. I understand that if the inn is unable to obtain approval on above mentioned card, that the inn will require an alternate form of payment and reservation will not be guaranteed.