Reservations...

At present, contributions are made based on each guest's ability to pay. The suggested donation is $25.00 per night, per person for lodging in the Main House. Bone Marrow apartments can be reserved through the Social Work department at Roswell Park Cancer institute

Please submit this form and we will be in touch with you regarding our room availability: (All fields are required)

Patient Name:
Person Making Reservation:
Names of Guests that will be staying at Kevin Guest House (including patient, if applicable):
Phone Number	- -
Cell Phone	- -
E-mail address
Arrival Date	Month Jan 2010 Feb 2010 Mar 2010 Apr 2010 May 2010 June 2010 July 2010 Aug 2010 Sept 2010 Oct 2010 Nov 2010 Dec 2010 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Approx. arrival time: (Sat. & Sun. before 10am or after 6pm)
Departure Date	Month Jan 2010 Feb 2010 Mar 2010 Apr 2010 May 2010 June 2010 July 2010 Aug 2010 Sept 2010 Oct 2010 Nov 2010 Dec 2010 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Hospital Name:
Stayed here before?	Yes    No
Date of Prior Stay
All bedrooms are upstairs. Able to do stairs unassisted?	Yes    No
3rd Floor?	Yes    No
Share queen size bed with person accompanying you?	Yes    No   NA
Please indicate any specific questions or comments below: