This application is made to rent premises known as: Hana Aloha Hale, 6820 Hana Highway, Hana HI.  Phone: 808-248-7627

Occupancy: __________

Preferred Arrival date: __________

Preferred Departure Date: ___________

Number of nights: ____________

Rates: $175 per night per couple and $75 per additional bedroom. Ask about long term rates.
A general excise & travel accommodation tax will be added.

Total rent is payable in advance. The following deposits are required.

The reservation deposit of 25% of the total rent and a security deposit required depending on length of stay is due with this Application. The balance of is due no later than 14 days before occupancy. 

The home is cleaned before the party's arrival. Any damage or excessive cleaning incurred during your stay will be charged to your credit card.

The applicant understands that if this Application is accepted and the Applicant fails to complete payment by the date specified above, the security deposit will be returned and the reservation deposit forfeited as liquidated damages. When the rental period is over, the security deposit will be returned after the premises have been inspected by the landlord (or his agent) and the phone bill checked for long distance usage; these amounts will be debited from deposit. (Deposits are typically returned within 30 days. If payment is made by credit card the security deposit will be waived, however the renter gives permission for the landlord to charge long distance telephone calls and damages to the credit card.

It is also understood that if the Application is not accepted, or if the premises are not ready for occupancy by the Applicant on the beginning date specified above, the deposit shall be returned to the Applicant.

Name of applicant:__________________________

Address:___________________________________

Home Phone:______________________ Work Phone:_______________________

FAX:____________________________ Email:______________________________

Credit Card#: __________________________  Expiration:____________

Do not email this document if you are providing your card number. Fax transmission or voice is secure.

No. of occupants:_______

Do any of your party smoke?  Yes  No
Hale Aloha Hale is a no smoking environment. Please show your consideration for other guests.

In case of emergency, contact:

Name:________________________

Address:________________________

Home Phone:____________________

I represent that the information provided in this Application is true and correct to the best of my knowledge.

I found Hale Aloha Hale at : _____________________________________

Applicant’s Signature:_____________________________________ Date:_____________________

Accepted:_________ Refused:_____________ Date:______________