Pay What You Can Application

Name: _______________________________________
Address:__________________________________________________________
_________________________________________________________________
Phone Number: ________________________________________
Email Address: ________________________________________
How many people in your party?
Adults __________ Children __________
Are you traveling with dogs (limited to 1)? Yes No
Have you (or will you have) been quarantined in the state of Maine, New Hampshire, or Vermont for 14 days prior to check in? Yes No
What type of Rental Unit would best meet your needs (circle one)?
Queen and twin room (sleeps up to 3) Queen and sofa room (sleeps up to 2)


Please list several dates that work for you below between June 12, 2020 and July 12, 2020 (2 night minimum). Rank your dates with the top choice as #1, second as #2 and so on, then put the price you can afford next to it. Please provide both a check in and check out date when filling out the form. Note, a 9% state sales tax will be added to the final total. There is a $10 per night pet fee.


#1 Preferred Dates: _________________What can you afford ($/night)? ____________________
#2 Preferred Dates: _________________What can you afford ($/night)? ___________________
#3 Preferred Dates: _________________What can you afford ($/night)? ___________________


                                                                                DUCKTRAP MOTEL
                                                                           LINCOLNVILLE, MAINE
                                                                                    207-789-5400
                                                                         ducktrapmotel@gmail.com