MDTravel.ca - 22nd. Annual FALL Conference,
Mexico, 10 - 17 November 2012
!. Name, as on passport
Date of birth dd/mm/yy
2. Name, as on passport
Date of birth. dd/mm/yy
Home Address
BOOKING FORM
Home Tel.
Office Address
Email.
Office Tel
Office Fax
A deposit of $500 per person is payable on booking. The balance with taxes and conference fee, will be deducted from the credit card on September 2nd 2012
Credit Card Visa/ Mastercard
Number
Exp.
Name on Card:
Signature
TRAVEL INSURANCE (Recommended)
Yes
No
Medical Insurance.
CONFERENCE REGISTRATION.
1. Name on Tag.
2. Name on Tag.
I would be willing to make a short presentation.
Yes
No.
Payments are made to a Registered Travel Agent, Uniglobe Voyageur Travel, Newmarket.
For further travel information, please call Jill Nunn of Uniglobe 905 895 2433
You may complete this form on line, and press the "Submit" button, or Print this form and mail to :
MDTravel, 192 Legendary Trail, Stouffville ON L4A 1N4
Yes
No
