Bentsen Grove Application

"*" indicates required fields

Address of Site

Site #:*

Length of Stay

Arrival Date*

Departure Date*

Date*

Primary Guest*

Date of Birth*

Drivers License Number*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone*

Name

Phone Number

Email Address*

Type*

Park Model

Mobile Home

Manufacturer*

Model*

Width / Length*

Year

License Plate Number

Any liens on the RV, Park Model or Mobile Home? if yes,list names of leinholder(s)*

Please give a copy of title to the office to keep on file. Click the + to include additional fields

List Additional Occupants

Click the + to include additional fields

Full Name

Relationship

Phone

Vehicles

NOTE: Motorcycle(s) must be licensed and included in above information. Click the + to include additional fields

Make

Year

Style

Plate # / State

Color

In Case of Emergency*

( Not living With you ) Click the + to include additional fields

Name of closest relative

Relationship

Telephone

Do you have Pets on the site?

If yes, please list below. Click the + to include additional fields

Type

Color

Name

Breed

How did you first hear about Bentson Grove?*

Residents Name

If other

Have you (or any person you have named on this application) ever been evicted from a tenancy or left owing money?*

Do you (or any person you have named on this application) have pending criminal charges, or ever been convicted of, plead guilty or no contest to, any criminal offense(s) or had any criminal offense(s) other than traffic infractions that were disposed of other than by acquittal or a finding of “not guilty”?*

Promo Code (if applicable)

Current resident who referred you

Referral Promotion Only

Site Number

Resort person referring you lives in:

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Phone

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We can’t wait to meet you!