Reservation Form

*For same day appointments, please phone me as soon as possible

I am available from 12pm-12am.
Name you will be using for hotel registration **
City/State of residence
Occupation:
Provider References:

Memberships: (Check all that apply)

Room Service2000 Date Check Preferred 411 TER White List
Board handle / ID:
Phone number you can be reached at **
Best time to call you is Time: - Time Zone
*When I call you, I will say that I am "Kit, of Desert Travel in Las Vegas"
Date: Month Day Year and Time requested for date.
Duration of date: hours.
Arrival date: Month Day Year
Departure date: Month Day Year
Where you will be staying
*Tell me a little about yourself: Favorite Music/Pet Peeves/Special Requests/etc
Enter email address **
Re-enter email address **
**Required Fields
*If you are a smoker, I'd greatly appreciate it if you would please refrain from smoking prior to my arrival and for during our time together in the room. My allergies and I thank you so much.

Kit Dubois
3053 West Craig Rd.
Suite E #155
North Las Vegas, NV 89032