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18022 N Hogback Rd, Luther, OK 73054

(405) 300-0343

Country Home Estates RV Park Application

First & Last name

Email

Phone

Birth Date

Drivers License

Co-Applicant (Name, Phone Number, Drivers License #)

Estimated Arrival Date

Number of Occupants

Name of Occupants

Pets? If so, please provide detail

Address

Current Employer

Company Address

Supervisors Name & Phone #

Start Date

Title & Length of Emplyment

Estimated Monthly Income

RV Make & Model

RV Year

License Plate #

Length of RV

30 Amp

50 Amp

Slideouts?

RV Insurance Provider

Policy #

Please Provide Emergency Contact (Name, Phone Number, Relationship)

Previous RV Park/Campground

Contact (Name & Phone Number)

What is the reason for moving from your current place?

Mon-Sun: 8 AM-5 PM