Registration Form - Travel Pursuits 2009

Please fill in the following registration form. For each trip, a $500 non-refundable deposit per person is due at registration. Online payment is not available. We will be in touch by phone to confirm your selections and arrange payment.

Due to fluctuating exchange rates all prices are quoted in Canadian dollars only; all prices for Canadian destinations include Canada’s Goods and Services Tax (GST).

Step 1: Contact Information (* Denotes Required items)

Registrant
Name*
Email Address*:
Address*:
City*:
Province/State*:
Postal/Zip Code*:
Country*:
Phone Number*:
Alternate Phone Number:
Fax Number :

Step 2: Trip Selection

Please indicate which trip(s) you would like to register for:

Register	TRIP		DATES	NIGHTS	LOCATION	DEPOSIT	PRICE	SINGLE SUPP
	A More Perfect Union	Visions of America then and now	Oct. 4 – 8, 2009	4	Philadelphia	$500.00	$1,800.00	$350.00

Step 3: Accomodation Preferences Please indicate your accomodation preferences:

Step 4: Flight and Other Travel Arrangements

Please check this box if you would like to request flight assistance and/or pre or post trip hotel reservations from our Travel Partner.

Anti-spam Question Is fire hot or cold?
- This confirms that this is a legitimate registration.

Note: The input below should not be filled in. It is a spam trap. Please ignore it. If you populate this input, the form will return an error.

Submit Form Please review your selections and then click the submit button.
Check this box if you want a carbon copy of this email.