Have you stayed with us before?                                     * = Required Information

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Where did you learn about the 29 Palms Inn?  *

-- Please Select One-- Referred by Friend or Relative Browsing the Internet Travel Guide Magazine or News Article Chamber of Commerce Other

Please provide the following contact information:

Name	*
Street Address	*
Address (cont.)
City	*
State/Province	*
Zip/Postal Code	*
Country
Contact Phone	*
FAX
E-mail	*

Arrival Date: mm/dd/yy    *      Departure Date: mm/dd/yy   * 

Number of Nights:  *

 Number of Adults?  *  Number of Children?     Number of Pets?

Bed Requirements?

            Number of queen size beds?

            Number of single beds?          

How many rooms do you need?   *

Room Preference #1:     ---Select--- Adobe Bungalow Wood Frame Cabin House Apache Plume Buffalo Burr Cinch Weed Dandylion Encelia Forget-Me-Not Goldenbush Hyacinth Tidy-Tips Cabin-X Cabin-Y Cabin-Z The-Hermitage Old Frame 1 & 2 Faultline Gold Park The Penthouse The West End The Guest House MacKenzie Suite Faultline and Gold Park Irene's Adobe The Dark Room The Bottle Room

Room Preference #2       No Second Preference Adobe Bungalow Wood Frame Cabin House Apache Plume Buffalo Burr Cinch Weed Dandylion Encelia Forget-Me-Not Goldenbush Hyacinth Tidy-Tips Cabin X Cabin Y Cabin Z The Hermitage Old Frame 1 & 2 Faultline Gold Park The Penthouse The West End The Guest House MacKenzie Suite Faultline and Gold Park Irene's Adobe The Dark Room The Bottle Room

Other Comments or Questions Regarding Your Request