Reservation Form

 

Jass Casino Tours

Reservation Form
* – Required field

 

Trip date*____________________Hotel*____________________

 

Accommodations:  1 Bed   2 Beds   Smoking   Non-Smoking   Handicapped

 

Last Name*    

 

First Name/s*

 

Address* Apt./Suite

 

City*   State*   Zip Code*

 

E-mail

 

Home Telephone*    

 

Work Telephone ext.

 

*Date of Birth

 

I/we will board the bus at:

 


 

I / We will be sharing a room with:( Please fill out this portion if other than spouse)

 

Last Name

 

First Name

 

Address   Apt./Suite

 

City   State   Zip Code

 

E-Mail

 

Home Telephone

 

Work Telephone ext.

 

*Date of Birth

 

I/we will board the bus at:   

 

Price per person:         # of people:    Total amount:

 

 

 


complete this form, print and mail to:
Jass Tours
105 Emerald Way West
Granite City, IL  62040

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