Application Form: HERITAGE TREASURES OF THE MIDDLE EAST
March 14 - 28, 2010
NAMES EXACTLY AS APPEARS IN PASSPORT, LAST & FIRST NAMES ONLY
FAMILY NAME: [1]
FIRST NAME:
Mr.
Mrs.
Ms.
FAMILY NAME: [2]
FIRST NAME:
Mr.
Mrs.
Ms.
MAILING ADDRESS:
CITY:
POSTAL CODE:
TELEPHONE #
[DAYTIME]
:
EMAIL:
PASSPORT#: [1]
DATE OF EXPIRY:
CITIZENSHIP:
PASSPORT#: [2]
DATE OF EXPIRY:
CITIZENSHIP:
Make a photocopy of your passport and mail it with your application form and deposit of $350.00 per person
DATE OF BIRTH: [1]
DD
/ MM
/ YYYY
DATE OF BIRTH: [2]
DD
/ MM
/ YYYY
ROOM TYPE:
Two Twin Beds:
/ One Double Bed:
/
I Require Single Room @ Extra Cost: $284.00
EMERGENCY CONTACT IN the US:
Name:
Daytime telephone contact number:
Please indicate if
special meals
required on flights:
Do you require assistance at airports:
HeritageTreasures_form100121
