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B&B MidWest Directory
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Accommodations Registration Request Form
(If you would simply like to make an inquiry, please use our Contact form.)
"Our stay was wonderful and centrally located for all of our plans. The house was lovely. The reservation service was so helpful!" - M. Luther & S. Eric

Please fill out the following information about your stay in a Bed & Breakfast/Resort accommodation in the MidWest associated with B&B MidWest Directory.
PLEASE NOTE: Filling out this form does not represent a confirmed reservation. Cancellation policies according to terms of particular reserved accommodation. 
You will be contacted regarding a room availability to match your request! 
Host Location:

First Name:Last Name: 
First & Last names of other occupants:  
Number of children in party: Children's age range:  
Street Address:  
City, State, Zip Code:       
Home Telephone:Office Phone:FAX:E-mail: 
Items in bold MUST be completed. 
Employer's Street Address:  
City, State, Zip Code:       
Travel Information 
Arrival Date:Arrival Time:Departure Date: 
Location Information:Transportation Method: 
Items in bold MUST be completed. 
Accommodation Information 
How were you referred to
B&B MidWest Directory?:
Purpose of trip:  
Should this be kept a surprise from other guest(s)?: No Yes 
Special Request:
Jacuzzi  Fireplace  Private Bath  2 or more rooms 
Double/1 Bed  King/Queen Bed 
Non-Smoking  Smoking  Full Breakfast 
Handicap Provisions*  Pets*  Allergies* 
*Please detail your specific situation below
Other Request:  
Please note: An attempt will be made to meet all special requests but you will be informed when a particular need can not be made by the location you have requested. 
Please answer:
Please call us at 847-433-3140

Reservation Inquiry  
Your request will be filled on a first come first serve basis. The individual host will call you at the number(s) provided above or contact you via email to confirm your reservation.  

  ** B&B MidWest Directory is a FREE SERVICE for
MidWest bed and breakfasts.
No additional fees are ever added. **

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