This tour price reflects special group rates.
Deposits received after July 28, 2009, will likely incur additional charges due to supplier contract terms.

To be assured of reservations, please complete and mail this registration form to:
Dr. Pauline Coffman, 623 South Euclid Avenue, Oak Park, IL 60304, along with your deposit of $500 per person.

Enclosed is my deposit check of $__________
($500 per person. Please make check payable to Middle East Traveling Seminar.)

(Please Print - name(s) as they appear in passport)

Name 1: ___________________________________________________________________

Name 2: ___________________________________________________________________

Address ______________________________________________________________

City, State, Zip ______________________________________________

Phone(evenings) _____________________(day) _____________________ Fax _____________________

E-Mail Address ________________________________________________________

Room Type:  Twin/Double Single

Rooming With:  __________________________________________________________

Travel Protection Insurance:

 I/we wish to be covered by travel protection insurance as follows:

 $280 per person (Please include this payment for travel insurance along with your deposit payment.) Insurance payments are not refundable.

 I DO NOT wish to be covered by travel insurance.

Signature:  __________________________________________________________

Please use this space if second person has a different address, OR if more than two persons are traveling from the same address.

  _______________________________________________________________________________________________

  _______________________________________________________________________________________________

  I have read and understood the Tour Features and Conditions and agree to the terms therein.

Signature:  __________________________________________________________

HLC110209LCLW CST 2013363-40 www.mtstravel.com