Holy Land Tour 2011 - Registration

To register, print, fill out and send this in with your deposit to:

Rev Dr Rom A Pegram

Dodgeville UMC
327 N Iowa St
Dodgeville, WI 53533

 Make checks payable to “Maranatha Tours Inc”

REGISTRATION  FORM

Enclosed is my/our $______ deposit ($300 per person).  Please reserve ______ seats on this trip.

Name__________________________________

Street__________________________________

City________________State_____Zip________

Phone __________________________________  

E-Mail_________________________________

Reserve domestic air from _________________

__ I do request a single room @ $55 per night.

__I opt out of the Insurance of $176 (Israel)

1/8/2011          
Pastor Rom A. Pegram