Visitor Guestbook and
Information Packet request form

Required Fields have an asterisk*
*Date: mm/dd/yy

*First Name:
*Last Name:
Email Address:

*Mailing Address:
  Mailing address line 2
*City:   *State:    
*Country:     *ZIP:
Permanent Address? Yes No

Would you like to receive a Beatty, Nevada Visitor Information Packet?

Would you like to receive Relocation Information about Beatty?

Would you Like to Receive information about future events in and around Beatty?

Thank you for your interest in Beatty, Nevada. Our wish is to serve you in the best way we can. To help us serve you better, please fill out the following visitor interest survey.

Dates you plan to visit the area:
Number of days planned in the Beatty area

Is this your first Visit to the Beatty, Nevada area? Yes No

Number in your household: Adults 18-25 26-35 36-45                         46-55 56-65 66-75 Over 75   
Children Under 6 6-12 13-17  
Pets    Live Stock   

How many persons will be in your traveling party?

What is the primary reason for the trip you are planning: Other
For multiple Choices, hold down the "Ctrl" key while making choices.

Is there a secondary reason for the trip you are planning:
Yes No
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What form(s) of transportation will you use on your trip?
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Which Types of activities are you likely to participate in on your trip?
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Employed? Yes No
Retired? Yes   No

Occupation of primary wage earner
Occupation of secondary wage earner

Please tel us how your heard about Beatty, Nevada
Check all appropriate boxes:
Personal Experience
I heard about Beatty from a friend or Relative
I have seen Beatty adds in:
I found you on the Internet
I discovered Beatty while traveling
I read about Beatty in a travel guide/article
Other:

Comments or Special Requests