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Request For Proposal

First Name*
Last Name*
Address*
City*
State*
Zip Code*
Company / Group*
Phone Number*
Email Address*
Preferred Arrival Date*
Preferred Arrival Date
Will you consider other dates?*
1. Yes
2. No
Location Preference*
1. Wilkes-Barre
2. Hazleton
3. No Preference
Preferred Departure Date*
Preferred Departure Date
Number of Nights*
Number of Sleeping Rooms (10 Minimum)*
Meal Requirements:
For Breakfast
For Lunch
For Dinner
Provide any other specifics for meeting room, hospitality suites, etc.

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1. Receive an email copy of this form.
Email address

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