It is our pleasure to accept your credit card for payment on the account of your designation. This form allows us to follow your authorization details, and is restricted for use only for the person, charges and dates you specify.
FAX TO
NAME:
RETURN TO
ATTN: Reservations
COMPANY:
FAX NUMBER:
GUEST NAME:
PHONE: 503-228-2000
FAX: 503-471-3920
ARRIVAL DATE: NUMBER OF NIGHTS:
PLEASE BILL THE FOLLOWING CHARGES FOR THE ABOVE GUEST TO MY CREDIT CARD :
 ROOM AND TAX  PARKING  INCIDENTALS  CATERING
 OTHER:______________________________________________________________
Following Guest Departure, please mail an Itemized Invoice to:
NAME:
COMPANY:
STREET:
CITY / STATE / ZIP CODE:
TELEPHONE:
P HOTOCOPY FRONT OF C REDIT C ARD
AND ATTACH HERE .
P HOTOCOPY BACK OF C REDIT C ARD
AND ATTACH HERE .
PLEASE NOTE THAT CARD WILL NOT BE APPROVED FOR AUTHORIZATION
WITHOUT A PHOTOCOPY.
SIGNATURE: ___________________________________ DATE:______________________
CREDIT CARD NUMBER: ________________________ EXPIRATION:_______________