The Christian-Travel Network Registration/Renewal Form

 1-Year Listing only $49.95

This Is An SSL Secure Form For Your Protection

Business Name:

Choose One or More: 
  B&B or Inn            Resort or Hotel         Restaurant         Attraction

Address:

Town/City:     County: not COUNTRY       State:             Zip:

Tel:   Fax:   Toll Free:       

Principals Name:

Choose One or More: 
  Innkeeper         Owner         Manager         Chef/Owner

E-Mail Address:     Website Address:

Located In or Near This Well Known Region:

Choose Listing Type:
  Standard @ $49.95         Standard w/ Text Message @ $69.95         Pictorial Webpage @ $99.00   

Add This Option:
  Inn of the Month on your State Page for 1-Year @ $149.00         

Photo(s) of our establishment:  
  Take from 0ur website         Will E-Mail       Will Snail-Mail       

Local Churches:

Local Attractions & Things To Do:

Credit Cards We Accept:
   VISA     Mastercard    Discover    AMEX

Make Payment

Card Type:     VISA        MasterCard        Discover        AMEX

Card No:       Exp. Date:         3-Digit Sec. No:

Cardholders Name:

Cardholders Address:

Tel. No: (If different From Above)

E-Mail Address: (If different From Above)

 

To Send This Form By Fax:
Fill-out, print out and fax to
631 980- 3856

For Payment by Mail: Please mail check to Ron Cusano, 88 Florida Ave., Commack, NY 11725.  Listing cannot be added until payment is received.