Canadian Rockies

EAST TEXAS BAPTIST UNIVERSITY Traveling Tigers
Canadian Rockies 2009
June 1-9
Tour Group Passengers Booking Form
Single/Double/Triple Occupancy

Sponsored by the ETBU Alumni Association

Host: Paul Tapp, Director of Alumni Relations
        (903) 923-2042
        ptapp@etbu.edu

Departure will be from Dallas/Ft. Worth
Single Occupancy - $3186
Double Occupancy - $ 2599
Triple Occupancy - $ 2500

A deposit of $350 per person is due at time of booking. Installment payments may be made with check, credit card or automatic bank draft. Final payment due April 15, 2009.

ADULT PASSENGER #1
Room Type*	Single Double Triple
First Name*
Last Name*
Address*
City*
State*
Zip Code*
Home Phone*
Cell Phone
Emergency Phone*
Email
Passport Number*
Date of Issue*
Date of Expiration*
Date of Birth*
ADULT PASSENGER #2
Room Type	Single Double Triple
First Name
Last Name
Address
City
State
Zip Code
Home Phone
Cell Phone
Emergency Phone
Email
Passport Number
Date of Issue
Date of Expiration
Date of Birth
ADULT PASSENGER #3
Room Type	Single Double Triple
First Name
Last Name
Address
City
State
Zip Code
Home Phone
Cell Phone
Emergency Phone
Email
Passport Number
Date of Issue
Date of Expiration
Date of Birth
CHILD #1
First Name
Last Name
Age
Passport Number
Date of Issue
Date of Expiration
Date of Birth
CHILD #2
First Name
Last Name
Age
Passport Number
Date of Issue
Date of Expiration
Date of Birth
SPECIAL NEEDS INFORMATION
Medical
DIET
CREDIT CARD INFORMATION
Type*	Visa Mastercard Discover American Express
Number*
Expiration Date*
Amount*
All fields marked with an asterisk (*) are mandatory.