Please type names as they appear on your Passport...... Complete the entire form and fax or mail to Mater Dei Tours

 

Printable Tour Registration Form
Please Type Your Information

Passenger Information
Please Type Your Information

1st Passenger: (required) ...2nd Passenger: (required)
Date of Birth.: ...Date of Birth:
Passport No.: ...Passport No.:
Passport Date of Issue: ...Passport Date of Issue:
State of Birth: ...State of Birth:
Current Address: ...Current Address:
City, State, Zip Code: ...City, State, Zip Code:
Phone Number: ...Phone Number:
E-Mail Address (required): ...E-Mail Address :
Name on Nametag: ...Name on Nametag:
Room Type Single (1 adult in room - please check tour for single supplement)
Twin: (2 adults sharing room with single beds)
Double: (2 adults sharing room with one bed)
Triple: (3 adults sharing one room; bedding varies)

Tour Information

Please Mark the Tour you wish to join:
Guadalupe - February 22, 2008
Guadalupe - Feb 29, 2008 Relevant Radio
Guadalupe - March 7, 2008
Guadalupe - December 8, 2008
Holy Land - April 11, 2008
Holy Land - June 19, 2008
Holy Land - October 29, 2008 Relevant Radio
Italy - August 17, 2008
Italy - September 15, 2008
Italy - November, 2008
Lourdes,Nevers & Paris - May 22 Relevant Radio
Shrines of Blessed Mother - May 12, 2008
Shrines of Blessed Mother - October 8, 2008
Poland - July 18, 2008 Relevant Radio
Portugal - September 15, 2008
I accept the terms and conditions of this tour Yes: No:
Do You Want Travel Insurance Information: Yes: No:

Printable Credit Card Form
Please Type Your Information

Credit Card Type: Master Card: Visa:
Expiration Date
Credit Card Number
Credit Card Security Code *Last 3 digits found on signature strip of the backside of card
Amount you Authorize to charge
Name on Card
Billing address
City, State, ZIP :
Telephone Number :

*Signature (please print form and sign)

*With my signature above, I approve the charges above and I declare that I have read, understand and accept this tour's Terms and Conditions.
In Lieu of my credit card I hereby authorize Landa Cleary Travel Co., Inc. to use my credit card above on my behalf, solely to charge the amount indicated as a deposit or balance payment for myself and or the people registered on this official registration form for the Tour I have indicated above.

Questions & Requests
Please Type Your Information

Any questions or special needs, please detail below:

Please fax completed forms to (608) 849-4247
or Mail to:
Mater Dei Tours
C/O Landa Cleary Travel
P.O. Box 323
Waunakee, WI 53597-0323

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