Registration Form - Travel Pursuits 2012

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.

All prices for Canadian destinations are subject to Canada’s Harmonized Sales Tax (HST).

Step 1: Contact Information (* Denotes Required items)

Registrant Information:
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
	Taking Your Soul For A Stroll - WAIT LIST ONLY	Oct 15 – 26, 2012	11	Spain	CAD $500	CAD $5695 pp	CAD $995
	Vietnam Voices: A Balanced Opposition	Oct 29 - Nov 12, 2012	14	Vietnam and Cambodia	USD $500	USD $5195 pp	USD $1250

Step 3: Accommodation Preferences Please indicate your accommodation 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.

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Submit Form Please review your selections and then click the submit button.
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