St. Luke’s Chancel Choir Spanish Tour Registration Form

ST. LUKE’S CHANCEL CHOIR SPANISH TOUR May 23 – June 2, 2015 Name(s)_(as they appear on your passport(s) Please register me for single occupancy ____ Please help me find a roommate _____ #1_________________________________________________________________________ #2_________________________________________________________________________ Address ____________________________________________________________________ City/State ____________________________________ HomePhone_______________ #1 E-Mail____________________________________________Cell__________________ #2 E-Mail ____________________________________________ Cell___________________ #1 Date of Birth ___________________________

#2 Date of Birth______________________ #1 Passport Number_______________

#2 Passport Number __________________ #1 Passport Expiration Date __________ #2 Passport Expiration Date ____________ I/We would be interested in a 4 night extension to: (please select one) Morocco _________ Southern France _________ Southern Coast of Spain _________

Payment Schedule Checks made out to: “Travel to Remember” Memo: “St. Luke’s Choir 2015” Deposit of $500 per person – by September 15, 2014 Second Payment of $1500 per person – by December 15, 2014 Final Payment of balance –tbd – March 1, 2015 Please print this and mail with your checks to: Travel to Remember Attn: Bob Zehr 621 Timber Mill Lane Indianapolis, IN 46260