subject_line
Name
(Full name on account)
*
Email
*
Owner #
Address
*
City
*
Zip Code
*
State
*
Other
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Phone
*
Is this a new mailing address?
*
Yes
No
Building
*
Alii
Banyan
Coral
Lika Lani
Unit Type
*
1B/1B
2B/1B
2B/2B
BES
Number of Adult Guests
*
1
2
3
4
5
6
Number of Child Guests
0
1
2
3
4
5
1st Choice
+
thru
+
Day
Thursday
Friday
Saturday
2nd Choice
+
thru
+
Day
Thursday
Friday
Saturday
3rd Choice
+
thru
+
Day
Thursday
Friday
Saturday
Special Unit Request
(optional)
I am
requesting usage at Lawai Beach Resort
I am request to space bank with
HTSE
II
ICE
RCI
SF Ex.
TPI
Exchange Membership #
Signature
(Type Name)
*
Date
*