RESERVATION APPLICATION for Marian Travel Service

 Please review our TERMS & CONDITIONS and TRAVEL INSURANCE

 You may also print this form, complete it and mail.

 Included = Required Fields

 Reservation Made By
Name                             
 Tour Information
Departure Date               
Destination                     
 Group Leader                 Marian Travel Service
 Post Tour Option             

 Reservation Information

Title

First Name

    Middle Name
Last Name
    Suffix
    I Prefer to be called

Birth date

Year:

 

Address*

* not a PO Box

City

State

Zip Code

Home Phone

    Work Phone

    Fax

E-Mail

 

Departure City 

Accommodations
    Preferred Roommate
    Preferred Roommate
    Valid US Passport Yes
    Passport #
    Expiration Date
    Insurance

Yes (additional  $129)

                *  pre-existing conditions Only * covered if purchased with initial deposit)

 

Wheelchair Request
Special Meal Request
Seat Request

Special Request

:::: Additional Comments or Information :::::


 I wish to make a direct credit card  payment (Only * possible if more than 60 days prior to departure) 

           Name on Credit Card                 

           Type of Card                     Visa       Master Card       American Express       Discover

           Card Number                          Exp. Date  

           Amount to be charged       

           Charge the $400 per person deposit now

           Charge the $400 per person deposit & $129 insurance now

           Charge $400 per person deposit now & the balance due 70 days prior to departure

           Charge $529 per person deposit and insurance now & the balance due 70 days prior to departure

           Charge total trip costs


  I wish to make my payment via  Check or Money Order.   I will send my payment by mail.

A $400 per person deposit is due at the time of booking.

If paying by check mail to: 

Marian Travel Service 13323 Castel Rock Drive,  Sun City West AZ 85375

# of people:   x  $400 Deposit/Payment in Full*  =  $ 

*(Full payment due if booking made within 60 days of departure)

Enrollment in and payment of the tour constitutes your acceptance of all the

Terms & Conditions for above mentioned trip.

 

   Initial Here to Agree to  all Terms and Conditions for this trip

 

 

 

Please review our TERMS & CONDITIONS and TRAVEL INSURANCE

 

If you have any questions please contact Phone: (623) 546-8668  or e-mail mirarizona@att.net

 

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