www.hotelcreditassociation.com Open in urlscan Pro
2606:4700:3036::6815:3599  Public Scan

Form analysis
24 forms found in the DOM

Name: FORM_element366 — POST javascript:void()

<form method="post" name="FORM_element366" action="javascript:void()"><input name="FORM_Credit_Reference_Company_Name___" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element367 — POST javascript:void()

<form method="post" name="FORM_element367" action="javascript:void()"><input name="FORM_Credit_Reference_Company_Phone__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element368 — POST javascript:void()

<form method="post" name="FORM_element368" action="javascript:void()"><input name="FORM_Credit_Reference_Contact_Name___" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element369 — POST javascript:void()

<form method="post" name="FORM_element369" action="javascript:void()"><input name="FORM_Credit_Reference_Contact_Title__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element370 — POST javascript:void()

<form method="post" name="FORM_element370" action="javascript:void()"><input name="FORM_Credit_Reference_Contact_Email__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element371 — POST javascript:void()

<form method="post" name="FORM_element371" action="javascript:void()"><input name="FORM_Credit_Reference_Contact_Fax____" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element372 — POST javascript:void()

<form method="post" name="FORM_element372" action="javascript:void()"><input name="FORM_Credit_Reference_HCA_File_______" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element373 — POST javascript:void()

<form method="post" name="FORM_element373" action="javascript:void()"><input name="FORM_Credit_Reference_Cust__Company__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element374 — POST javascript:void()

<form method="post" name="FORM_element374" action="javascript:void()"><input name="FORM_Credit_Reference_Cust__Address__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element375 — POST javascript:void()

<form method="post" name="FORM_element375" action="javascript:void()"><input name="FORM_Credit_Reference_Cust__City_____" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element376 — POST javascript:void()

<form method="post" name="FORM_element376" action="javascript:void()"><select tabindex="null" name="FORM_Credit_Reference_Cust__State____">
    <option value=""></option>
    <option value="Other">Other</option>
    <option value="Alabama">Alabama</option>
    <option value="Alaska">Alaska</option>
    <option value="Arizona">Arizona</option>
    <option value="Arkansas">Arkansas</option>
    <option value="California">California</option>
    <option value="Colorado">Colorado</option>
    <option value="Connecticut">Connecticut</option>
    <option value="Delaware">Delaware</option>
    <option value="District Of Columbia">District Of Columbia</option>
    <option value="Florida">Florida</option>
    <option value="Georgia">Georgia</option>
    <option value="Hawaii">Hawaii</option>
    <option value="Idaho">Idaho</option>
    <option value="Illinois">Illinois</option>
    <option value="Indiana">Indiana</option>
    <option value="Iowa">Iowa</option>
    <option value="Kansas">Kansas</option>
    <option value="Kentucky ">Kentucky </option>
    <option value="Louisiana ">Louisiana </option>
    <option value="Maine">Maine</option>
    <option value="Maryland">Maryland</option>
    <option value="Massachusetts">Massachusetts</option>
    <option value="Michigan">Michigan</option>
    <option value="Minnesota">Minnesota</option>
    <option value="Mississippi">Mississippi</option>
    <option value="Missouri">Missouri</option>
    <option value="Montana">Montana</option>
    <option value="Nebraska">Nebraska</option>
    <option value="Nevada">Nevada</option>
    <option value="New Hampshire">New Hampshire</option>
    <option value="New Jersey">New Jersey</option>
    <option value="New Mexico">New Mexico</option>
    <option value="New York">New York</option>
    <option value="North Carolina">North Carolina</option>
    <option value="North Dakota">North Dakota</option>
    <option value="Ohio">Ohio</option>
    <option value="Oklahoma ">Oklahoma </option>
    <option value="Oregon">Oregon</option>
    <option value="Pennsylvania">Pennsylvania</option>
    <option value="Rhode Island">Rhode Island</option>
    <option value="South Carolina">South Carolina</option>
    <option value="South Dakota">South Dakota</option>
    <option value="Tennessee">Tennessee</option>
    <option value="Texas">Texas</option>
    <option value="Utah">Utah</option>
    <option value="Vermont">Vermont</option>
    <option value="Virginia">Virginia</option>
    <option value="Washington">Washington</option>
    <option value="West Virginia">West Virginia</option>
    <option value="Wisconsin">Wisconsin</option>
    <option value="Wyoming">Wyoming</option>
  </select></form>

---

Name: FORM_element377 — POST javascript:void()

<form method="post" name="FORM_element377" action="javascript:void()"><input name="FORM_Credit_Reference_Cust__Zip______" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element378 — POST javascript:void()

<form method="post" name="FORM_element378" action="javascript:void()"><input name="FORM_Credit_Reference_Cust__Country__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element379 — POST javascript:void()

<form method="post" name="FORM_element379" action="javascript:void()"><input name="FORM_Credit_Reference_Function_Date__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element380 — POST javascript:void()

<form method="post" name="FORM_element380" action="javascript:void()"><input name="FORM_Credit_Reference_Function_Name__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element381 — POST javascript:void()

<form method="post" name="FORM_element381" action="javascript:void()"><input name="FORM_Credit_Reference_Advance_Deposit" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element382 — POST javascript:void()

<form method="post" name="FORM_element382" action="javascript:void()"><input name="FORM_Credit_Reference_Amount_Billed__" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element383 — POST javascript:void()

<form method="post" name="FORM_element383" action="javascript:void()"><input name="FORM_Credit_Reference_Payment________" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element384 — POST javascript:void()

<form method="post" name="FORM_element384" action="javascript:void()"><select tabindex="null" name="FORM_Credit_Reference_Adjustments____">
    <option value=""></option>
    <option value="Yes">Yes</option>
    <option value="No">No</option>
  </select></form>

---

Name: FORM_element385 — POST javascript:void()

<form method="post" name="FORM_element385" action="javascript:void()"><select tabindex="null" name="FORM_Credit_Reference_Repeat_Customer">
    <option value=""></option>
    <option value="Yes">Yes</option>
    <option value="No">No</option>
  </select></form>

---

Name: FORM_element386 — POST javascript:void()

<form method="post" name="FORM_element386" action="javascript:void()"><input name="FORM_Credit_Reference_Opening_Date___" type="text" value="" maxlength="500" tabindex="null" style="width:100%;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;">
</form>

---

Name: FORM_element387 — POST javascript:void()

<form method="post" name="FORM_element387" action="javascript:void()" style="height:100%"><textarea name="FORM_Credit_Reference_Comments_______" wrap="hard" tabindex="null"
    style="width:100%;height:84px;font:13px Arial,Helvetica,adobe-helvetica,Arial Narrow;"></textarea></form>

---

Name: FORM_element388 — POST https://www.homestead.com/~site/siteapps/CustomFormSubmission.action

<form method="post" name="FORM_element388" target="_parent" action="https://www.homestead.com/~site/siteapps/CustomFormSubmission.action"><input value="CMDSubmitFormElement" name="CMD" type="hidden"><input
    value="https://hotelcreditassociation.com/HospitalityCreditReference.html" name="BACKPAGEURL" type="hidden"><input tabindex="null" name="FORM_SUBMIT_Credit_Reference_Submit_Button__" type="button" value="Submit"
    onclick="ProcessHSForms(document.forms[Trim('FORM_element388')])">
  <div style="display: none"><input name="MESSAGE" type="text" style="" size="1" maxlength="30"></div><input
    value="FORM_Credit_Reference_Company_Name___;FORM_Credit_Reference_Company_Phone__;FORM_Credit_Reference_Contact_Name___;FORM_Credit_Reference_Contact_Title__;FORM_Credit_Reference_Contact_Email__;FORM_Credit_Reference_Contact_Fax____;FORM_Credit_Reference_HCA_File_______;FORM_Credit_Reference_Cust__Company__;FORM_Credit_Reference_Cust__Address__;FORM_Credit_Reference_Cust__City_____;FORM_Credit_Reference_Cust__State____;FORM_Credit_Reference_Cust__Zip______;FORM_Credit_Reference_Cust__Country__;FORM_Credit_Reference_Function_Date__;FORM_Credit_Reference_Function_Name__;FORM_Credit_Reference_Advance_Deposit;FORM_Credit_Reference_Amount_Billed__;FORM_Credit_Reference_Payment________;FORM_Credit_Reference_Adjustments____;FORM_Credit_Reference_Repeat_Customer;FORM_Credit_Reference_Opening_Date___;FORM_Credit_Reference_Comments_______;"
    name="FORM_SUBMIT_FIELDS_Credit_Reference_Submit_Button__" type="hidden"><input
    value="Thank you for providing a credit reference on your customer. Your information has been submitted to Hotel Credit Association and will be added to the HCA database." name="FORM_SUBMIT_THANKYOU_MSG_Credit_Reference_Submit_Button__"
    type="hidden"><input value="default" name="FORM_SUBMIT_THANKYOU_URL_Credit_Reference_Submit_Button__" type="hidden"><input value="BOTH" name="SUBMITMETHOD" type="hidden"><input value="1752284201" name="HSID_" type="hidden"><input
    value="867c309ed071073c011ccc6d99d7c7c832af6edcda88c2795849bd048acbf78615d365c84ae4f0fea97fd32ca8fe00a37573b8e63901ab15650c3429ab6faf66" name="ENC_ARGS" type="hidden"><input value="HospitalityCreditReference" name="FORMNAME_" type="hidden"><input
    value=" 1/27/2023 19:14:1" name="FORM_PUBLISH_TIME_" type="hidden"><input name="FORM_Credit_Reference_Company_Name___" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Company_Name___" value="null" type="hidden"><input
    name="FORM_Credit_Reference_Company_Phone__" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Company_Phone__" value="null" type="hidden"><input name="FORM_Credit_Reference_Contact_Name___" type="hidden"><input
    name="FORM_TAB_INDEX_Credit_Reference_Contact_Name___" value="null" type="hidden"><input name="FORM_Credit_Reference_Contact_Title__" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Contact_Title__" value="null" type="hidden"><input
    name="FORM_Credit_Reference_Contact_Email__" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Contact_Email__" value="null" type="hidden"><input name="FORM_Credit_Reference_Contact_Fax____" type="hidden"><input
    name="FORM_TAB_INDEX_Credit_Reference_Contact_Fax____" value="null" type="hidden"><input name="FORM_Credit_Reference_HCA_File_______" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_HCA_File_______" value="null" type="hidden"><input
    name="FORM_Credit_Reference_Cust__Company__" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Cust__Company__" value="null" type="hidden"><input name="FORM_Credit_Reference_Cust__Address__" type="hidden"><input
    name="FORM_TAB_INDEX_Credit_Reference_Cust__Address__" value="null" type="hidden"><input name="FORM_Credit_Reference_Cust__City_____" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Cust__City_____" value="null" type="hidden"><input
    name="FORM_Credit_Reference_Cust__State____" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Cust__State____" value="null" type="hidden"><input name="FORM_Credit_Reference_Cust__Zip______" type="hidden"><input
    name="FORM_TAB_INDEX_Credit_Reference_Cust__Zip______" value="null" type="hidden"><input name="FORM_Credit_Reference_Cust__Country__" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Cust__Country__" value="null" type="hidden"><input
    name="FORM_Credit_Reference_Function_Date__" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Function_Date__" value="null" type="hidden"><input name="FORM_Credit_Reference_Function_Name__" type="hidden"><input
    name="FORM_TAB_INDEX_Credit_Reference_Function_Name__" value="null" type="hidden"><input name="FORM_Credit_Reference_Advance_Deposit" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Advance_Deposit" value="null" type="hidden"><input
    name="FORM_Credit_Reference_Amount_Billed__" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Amount_Billed__" value="null" type="hidden"><input name="FORM_Credit_Reference_Payment________" type="hidden"><input
    name="FORM_TAB_INDEX_Credit_Reference_Payment________" value="null" type="hidden"><input name="FORM_Credit_Reference_Adjustments____" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Adjustments____" value="null" type="hidden"><input
    name="FORM_Credit_Reference_Repeat_Customer" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Repeat_Customer" value="null" type="hidden"><input name="FORM_Credit_Reference_Opening_Date___" type="hidden"><input
    name="FORM_TAB_INDEX_Credit_Reference_Opening_Date___" value="null" type="hidden"><input name="FORM_Credit_Reference_Comments_______" type="hidden"><input name="FORM_TAB_INDEX_Credit_Reference_Comments_______" value="null" type="hidden">
</form>

---

Name: FORM_element389 — POST javascript:ResetHSForms()

<form method="post" name="FORM_element389" action="javascript:ResetHSForms()"><input tabindex="null" value="Reset" name="FORM_Credit_Reference_Reset_Button___" type="submit"></form>

---

Text Content

Your customer has listed your business as a credit reference. They are applying
for direct billing at a hotel which has a contract with Hotel Credit Association
to verify credit references. Please fill out this form even if you do not have
any billing information. All information provided is strictly confidential.
Thank you.

Your Company Name  *

Your Name  *

Your Title  *

Your Email Address

Your Company's Fax #

Customer City  

Customer State  

Customer Company/Group Name  *

Please indicate any adjustments, revisions, disputes or special circumstances in
the space provided to the right

Customer Address

Customer Zip

Who you are providing a credit reference on:

(Please provide information below on your customer)

Customer Country

Function Name (if any)

Advance Deposit (if any)

Amount Billed  *

Payment History  *

Adjustments?

Month/Year Account Opened

Date Of Function/Stay  * 

Repeat Customer?

Your Company's Main Phone #  *

Who you are:

(Please provide information below on your company)

Billing details regarding your customer:

(Please provide information below on your customer's billing and payment
history)

HCA File #  *

* = required field

(What's this?)

(What's this?)

(indicate a specific BILLED & PAID date or provide the # of days it took for
your customer to pay)

(not including any advance payments)

(if no specific date is available, please indicate ongoing, monthly, not
available, etc.)


STRICTLY CONFIDENTIAL CREDIT REFERENCE




618-786-5100

info@hotelcreditassociation.com

PO Box 459 | Grafton, IL 62037




Please Contact Our Office Directly If You Have Any Questions Or Concerns











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