Prairie Dorm Rentals Payment Form  

Thank-you for your interest in renting facilities on Prairie's campus.
By providing preliminary information, you will help our staff serve you best.
(Items in Bold below are required.)
 
Stay Information
 
Reason for stay:
Room Type:
Stay Dates:
Check-in   Check-out      
<June 2018>
SMTWTFS
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567
 
<June 2018>
SMTWTFS
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567
Estimated Arrival Time:
 
 
 
Guest Information
 
Title:
Guest Name:
Guest Position:
Organization Name:
Email:
Phone #      Ext.
Address:
City:
Prov./State:
Post/Zip Code:
 
Comments or Questions
 
 
Credit Card Information
 
Name on Card:  
Card Type:  
Card Number:  
 Expiration:  
CVN/CVV2:  
(what is this?)   
  (optional)




   
 

Prairie Bible Institute
Box 4000
Three Hills, AB T0M 2N0
1-800-661-2425

Admissions
Giving to Prairie
Privacy Policy
Facility Rentals
Maps & Directions
Campus Safety
Events
Contact Us