REGISTRATION FORM

 

 

 

A non-refundable deposit of $250.00 per person is required to reserve space on the tour. After paying your deposit, you may choose to follow the arranged payment plan or just send in your final payment by  May 31, 2004

 

IMPORTANT NOTICE: Valid Passport is required when traveling outside of the United States. Depending on the countries being visited, entry visas may also be required. We provide complimentary visa service, however visa fees charged by the embassies together with passport size photos must be submitted with your visa applications. YELLOW FEVER INNOCULATION is needed to enter most African countries. Please check with your physician.

 

Please print the registration form and fill out to reserve your space.

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Please register me for Tour Code BWI/GH/TG/BN-102-04   Ghana/Togo/Benin (July 18 – Aug. 01, 2004).

US Departure City: Baltimore            Return City: Baltimore

 

The required non-refundable deposit on $250.00 per person is enclosed. For accurate posting, please write the above-mentioned tour code on all your checks, money orders, or Cashier’s checks tendered for payments. NOTE: 3% surcharge for payments with Visa, Mastercard.   4% surcharge for payments with American Express.

 

NAME:  (As it appears on you passport)______________________________________________

ADDRESS:____________________________________________________________________

CITY:________________________ STATE: ___________________ ZIP: __________________

TELEPHONE: (Home)___________________(Office)__________________________________

NAME OF ROOMATE:___________________________________________________________

E-MAIL:_______________________________________________________________________

 

Credit Card Payment: I,__________________________________ have authorized Intraworld Exch. Corp/Ghana America Vacations to charge my Visa/Mastercard/American Express credit card #______________________________Expiring _____ in the amount of $___________ as payment for myself and or _______________________________for the above-mentioned tour.

Signature of Card holder_______________________________Date________________________

 

Please make checks payable to:

GHANA AMERICA VACATIONS

1900 L Street NW, Suite 605,

Washington DC 20036

Tel:202-862-4959               Fax:202-862-4958

Toll Free 1-888-774-4262

E-mail intragav@aol.com