Registration Form - Print it out and mail it to us

INSPIRATIONAL TOUR OF ITALY

Hosted by

Rev. Karl and Dottie Schimpf

March 8 - 17, 2005

NAME (1)___________________________________________________________________

(Legal name as appears in your passport) - Please print

NAME(2)____________________________________________________________________

ADDRESS___________________________________________________________________

CITY_______________________________STATE________ZIP__________

MY ROOMMATE’S NAME IS:_________________________________________________

HOME PHONE: __________________________WORK PHONE: ____________________

DATE of BIRTH 1)____________________ 2) DATE of BIRTH____________________

PASSPORT NUMBER 1)_________________________ 2)_________________________

NAME TAG SHOULD READ: ______________________________________________

MY E-MAIL ADDRESS IS: ____________________________________________

·         Enclosed is my check/money order for deposit: ($400.00) per person ______

·         (Due on or before September 1, 2004)

·         I want a single accommodation for an added $395.00  Yes____ No____

·         I traveled ____ times with Heavenly Tours. (Please enter number of previous tours)

·         Early Bird reduction of $50.00 if deposit is paid by August 1, 2004 _____

I have read the Tour Conditions & Cancellation policy of the section of the brochure and understand the cancellation policy.  I understand that deposits are non-refundable and final payment is due January 15, 2005.  I also understand that if I wish to cancel my tour, the Terms and Conditions as stated in brochure will apply and be enforced. I am aware that I am responsible for adequate personal and medical insurance. (Please note that Heavenly Tours will be unable to proceed with your reservation without your signature on this form.)

SIGNED: _________________________________________ DATE_________________

Make check payable to:   

Heavenly International Tours

Mail this form with your deposit to:

HEAVENLY INTERNATIONAL TOURS

3900 W. Brown Deer Road

Suite A-134

Milwaukee, WI  53209

  (414) 352-6522 or (800) 322-8622