Jewish History Study Tour
Poland Tour Registration

(Items in red are required)

TRAVELERS' PASSPORT INFORMATION
* Full name must be exactly as it appears on your passport.
TRAVELER 1        
First Name Middle Name Last Name Date of Birth Gender
  Passport # Date Expires Place of Issue Citizenship
 
TRAVELER 2        
First Name Middle Name Last Name Date of Birth Gender
  Passport # Date Expires Place of Issue Citizenship
 
Total number of travelers: person(s).

CONTACT INFORMATION
Number & Street:
City: State/Zip:
Primary Phone: Secondary Phone:
Primary Email: Secondary Email:

EMERGENCY CONTACT INFORMATION (Required by Airlines)
Name:  Relationship
Primary Phone: Secondary Phone:
Address:
City: State/Zip:
Email:
RESERVATIONS

Airfare is not included in the price of the tour. Travel-On has successfully contracted with Air France for a group airfare of $712.10. Our group airfare offers a savings of over 45% from the regular non-group airfare. If you are interested in using our group airfare (requires at least 1- participants).please check the box in your tour application and we will do so. This fare is subject to change. Airfares are NOT guaranteed until the ticket is issued. We will also give you the option to pay for your airline ticket immediately to avoid any future fare and fuel increases and surcharges. If you prefer not to take advantage of the group airfare, we will gladly assist you with your individual airline reservations. At any time you will be able to purchase the land tour only and utilize your Star Alliance frequent flier miles to secure your airline seats.

I am interested in obtaining information about the proposed group airfare. Please contact me.
Please contact me to assist with making my airline reservations (non-group; individual)
I have arranged my own air.  Flight #: Arrival Date: Arrival Airport:
I will need a transfer from airport to hotel upon arrival.
I will need a transfer from hotel to airport upon departure.
I will need additional hotel stay in (city) for nights.
Select room type: Double Occupancy Single Occupancy
Bed Type: 1 Bed 2 Beds
Special hotel request:
I have read Terms and Conditions and would like information to purchase Trip Insurance.
I have read Terms and Conditions and declining Trip Insurance.
TOUR DEPOSIT

A deposit of $1,000 per person is required to guarantee a seat on the tour. Upon receipt of deposit, a confirmation will be sent to you via email.
Please use the following credit card for deposit in the amount of $ .
Credit Card Type: Card Number Exp Date Name on card
I hereby authorize Travel-On to charge to the credit card account(s) as indicated on this form, for any travel transactions requested by the traveler.

Submitted by ( your name): Today's Date:

REMARKS