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Mid Atlantic Monument Builders 2009 Convention - Passenger
Booking Form
Legal Name (as appears on passport):
__________________________________Birth date: ___________
Mailing Address:
___________________________________________________________________
City: ____________________________________ State: ______________ Zip:
_________________
Home Phone ( )
_______________________ Work Phone
( )________________________
2nd Passenger Legal Name:____________________________________ Birth date:
____________
3rd Passenger Legal Name: ____________________________________ Birth date:_____________
4th Passenger Legal Name: ____________________________________ Birth date:
_____________
Email Address(s):
____________________________________________________________________
Emergency Contact Name: _______________________________ Phone
( ) _________________
US Citizen? Yes or No If No, Citizenship:
________________________________________________
RCCL Past Guest #'s (if applicable): ___________________ Celebrity
or Azamara past guest # if applicable? _________
Any Special Needs:_____________________________ Any
Special Occasions:____________________
Stateroom Category Requested (circle one)
Inside Oceanview Balcony Suite
(Category)______________
Tampa Hotel Stay for 1-9-09 and one way transfer back to airport upon return
(price tbd): Yes or No
Or for those flying in the day of sailing
Round trip transfers to airport on 1-10-09 and back 1-15-09 ($39pp)
Yes or No
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Credit Card number:_____________________________
Expiration Date: _______ Security Code:______
Name as it appears on the
card:___________________________________________________________
Amount to be charged: $_______________________
Signature:_________________________________
If paying by check:
Checks are to be made payable to "CruisOne" and are subject to
electronic deposit. |
Jack Greenawalt's CruiseOne Agency/GPI Marketing
1000 North Front Street
Suite 240
Wormleysburg, PA 17043
Phone: 717-777-0060
Fax: 717-777-0061
Toll Free: 800-757-2784
jgreeenawalt@cruiseone.com
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