Mann's RV			MOTORHOME RESERVATION APPLICATION			RA#:  ________     CUST#: ________
		(508) 886-4745 Phone  (508) 886-0207 Fax
Date:		Unit:		Quote:		Mileage/Nights:
Applicant's Name:					Home Phone #:
Address:					Cell Phone #:
City/State:			Zip Code:		Fax #:
Driver's Lic. No.:			State:		DOB:		Lic Expires:
Insurance Co:					Social Security #:
Applicant's Email Address:
Any motor vehicle violations, suspensions, accidents in past three years?     YES         NO
If so, please describe:
Employer:					Phone No.:
Emergency Contact:					Phone No.:
Are you a previous rentor?   YES     NO    If not, how did you hear about us?
Addt'l Driver Name:					Phone No.:
Address:					Social Security #:
City/State:			Zip Code:		Insurance Co.:
Driver's Lic. No.:			State:		DOB:		Lic. Expires:
Any motor vehicle violations, suspensions, accidents in past three years?    YES       NO
If so, please describe:
Credit Card MC/V/DIS		Card No.:					Exp Date:
Name as appears on Card:							CCID#:
Requested Dates		From:		To:
Destination:				Round Trip Mileage:
Desired Unit:				No. of Occupants:		Adults		Children
Special Requests:
Are you interested in our Responsibility Reduction Waiver at $19.95/day?      YES      NO      UNSURE
If approved your reservation prepayment of, $500 for rentals totaling $750 or more/$250 for rentals totaling less than $750,
which is NON-REFUNDABLE will be charged to the credit card listed above, unless other payment arrangements have been made.
A reservation cannot be processed without the reservation prepayment, this will be applied towards the total rental charges.
The number of miles included in the rate will be determined by what the applicant listed in the round trip mileage field. If this field
is blank you will receive a basic package price with 100 miles/day.  In addition to your rental charges on the day of departure
you will be required to provide a security deposit of $800.00 CASH or MONEY ORDER. Refundable within 14 days of return
provided vehicle is in the same condition as at pick up. Pick-up times are after 1:00pm and return time is 10:00am SHARP.
All information will be verified via a credit check.  Applicant and additional drivers must be 25 years of age.
Applicant's Signature:						Date:
This is an application only and does not constitute a reservation or contract.  The person listed above
must be present at time of pick up.   By signing this form you have read and been given the opportunity
to ask questions regarding the terms and conditions on the reverse side of this form.
		TV/VCR, GENERATORS AND AWNINGS ARE NOT GUARANTEED!
		NO CREDIT FOR UNUSED MILEAGE OR EARLY RETURN!!!							rev. 05/06