Your Information:

Name: (Exactly as it appears on passport)

Address:

City: State: Zip: Country of Birth:

Home Telephone: Cell: E-mail Address:

Special Needs: (i.e. diet, sea sickness, wheelchair,etc.)


Personal Special Occasions Celebrated While on this Cruise:

Your Roommate's Information:

Roommate Name:

Home Telephone: Cell: E-mail Address:


Passport Information

Type of Passport: Passport Number:

Place of Issue: Date of Issue: Expiration date:

Place of Birth: Date of Birth: Occupation:

Emergency Contact Person:

Name: Relationship with person:

Home Phone Work: Cell:

Accommodations (Prices Based on Double Occupancy)

Inside Cabin $585/person con Oceanview Cabin $695/person con Balcony Cabin $795/person
(Room price does NOT include airfare) $100.00 non-refundable deposit per person required by May 10, 2008
Remaining balance due by September 1, 2008

Method of Payment

Check Money Order

Credit/Debit Card

Name (Exactly as it appears on credit/debit card)

Billing address (if different from home address)

Street address:

City State: Zip:

Visa MasterCard

Card # xxxExp. Date: xxx CIV#

If mailing a check/money order, make it to:
Alpha & Omega Travel
16096 Harmony Path
Lakeville, MN 55044-6319
Questions? kathy@alphaomegatravel.biz or mary@alphaomegatravel.biz
(952) 997-3822