Guest Registration Form
Information on this Form is Private and is NOT Shared with 3rd Parties
Please fill out the following information and click the
Send Registration
button at the bottom
Be sure to fill out all fields. Items with
*Red Star
must be filled out.
First Name:
*
Last Name:
*
Area Code and Phone:
*
E-mail Address:
*
Type of Accomodation Desired:
*
Select
Private BedRoom
Shared BedRoom
Efficiency
Private Apartment
Private House
Are You A:
*
Select
Yachtie
Student
Airline Crew
Marine Industry
Other
Please Specify:
*
Select
When Would You Like To Move In?:
*
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Year
How Long Will You Stay?:
*
Select
Weekly
Nightly
Monthly
Greater Than Monthly
Tentative Departure Date:
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Month
2008
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Year
Nationality:
*
How Did You Hear About Neptune Group?:
Select
Friend
Internet
Repeat Guest
Crew Agency
School
Other Crew House Recommended
Crew Agency Web
School Web Site
Driving Around
Publicity / Magazine
Other
Please Specify Other:
Will You Be Looking For a Job?:
Select
TBD
YES
NO
Comments Or Questions:
Max 250 charaters
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