Name: (Legal
Name: Same as on your passport. Please print)
First___________________________ Middle__________________ Last
_______________________
Male___ Female___ Date of
Birth: ________________Nickname? (Geraldine=Geri)_________________
Home
Address:______________________________________________________________________
City:
______________________________________ State: __________________ Zip:
____________
Telephone: Home:
____________________ Business: ___________________ Cell:________________
Email:
(**required)___________________________ Closest Airport to
Home:_____________________
Passport No:
_______________________________________ Expiration Date: __________________
Roommate
Name: (Legal Name: Same as on passport. Please print)
First___________________________ Middle___________________
Last_______________________
Male___ Female___ Date of
Birth: ________________Nickname? (Geraldine=Geri)_________________
Home Address:
_____________________________________________________________________
City:
_____________________________________State: __________________ Zip:
____________
Telephone: Home:
___________________ Business: ____________________ Cell:_________________
Email:
(**required)______________________________ Closest Airport to Home
__________________
Passport No:
_______________________________________ Expiration Date: ___________________
Please submit this
form with your deposit ASAP to secure your reservation and airline seating.
Enclose deposit of
$350 per person for_____ reservations. Total amount enclosed: $__________
Tour price based on double occupancy
(2 people per room).
Private room for single traveler add
$425. (Billed with final invoice)
Complete tour information & travel
guide will be sent to you upon receipt of this
reservation form and your $350 deposit.
You will be notified re: the
gateway city early in 2007. We handle all land & air arrangements.
Rooming Preference: _____ I want to
reserve a private room _____ Help me find a room mate.
*The quoted tour price is for
cash or check only. We are unable to accept credit card payments.
*Tour price as shown does not include
roundtrip domestic airfare to gateway city ($235),
airport tax, security fee, fuel
surcharge ($215) & visa processing ($110).
**Email address is required, as
pertinent info will be sent to you via Email.
Contact: Rev. Dr. Rainbow Johnson (512) 478-4944
rainbow@revrainbow.org
Reservation Consultants:
Marlene Winn (941)
795-4506 mmwinn@earthlink.net
Stephen Levin (888)
515-1885 regenttours@tampabay.rr.com
Make your check payable to:
Regent Marketing Group
Mail reservation form with check to:
Marlene Winn
7322 Manatee Ave W. #113
Bradenton, FL 34209
Is there anything else
you'd like us to know?
______________________________________________________________
______________________________________________________________
______________________________________________________________
