PLEASE PRINT Name as it appears on your passport

NAME ____________________________________________________________________________________

NAME Rooming with_________________________________________________________________________

ADDRESS_________________________________________________________________________________

__________________________________________________________________________________________

CITY___________________________________ STATE_________ ZIP________________

Phone (            ) _______________________

E-MAIL___________________________________________________________________________________

$500 (U.S.) per person deposit due with reservation form
Full payment due by Aug. 9, 2007

Credit card Visa (   ) MC (   ) #________________________________________________________________

Expiration Date____________________________________________________________________________

Signature__________________________________________________________________________________

Room: Single, additional charge (   ) Double (   ). Single price, add $600.

Travel insurance $149: Yes (   ) No (   )

Departure: Boston (   ) New York (   ) Chicago $100 add on (   )