Tour Information Required (2016 Israel Tour)

Please fill in one form per person. We also require a jpg or pdf emailed of your passport.
Alternatively you can send a copy to Fr Max Bowers, PO Box 484 Brighton. SA 5048.

Surname
Christian Name(s) as per passport
Preferred name to be called
Address including post code
Email Address
Phone Home Mobile
Passport Number
Date Passport Expires
Date of Birth
Birth City (As per passport)
Nationality on Passport
If married and partner still alive, wedding anniversary date
Contact person while you are overseas - Name/Address/phone
Contact relationship to you
Other Info

If you are a smoker check here

If you are a vegetarian click here

Do you have any special dietary requirements for meals?
Sleeping arrangements

Single beds (Two to a room)

OR

Double bed (Normally a queen size)

Single room accommodation (Additional cost $1700 Israel - Turkey $795)

I wish to share a room with...

I wish to share with

I have no preference and happy to share with anyone

Add Capital city you will be leaving Australia from

There is an additional cost .......
if you are not travelling from Melbourne, Sydney, Brisbane or Perth)

Airline information

I/We will be travelling back with the group to Australia

I/We are considering staying longer or travelling on to Europe or other locations. (If this be the case there is an additional cost of approx. $600 but would need to be confirmed ASAP with Fr Max to obtain an accurate costing)

Travel Insurance I understand this is my personal responsibility and the company I use is my own choice. Anglican Tours can offer suggestions if asked.
Give details of any medical background that may be useful if you need medical treatment in Turkey.

Direct Money Transfer Details
Westpac Bank
Grassroots Resources
BSB: 033 689
A/c: 311669
Reference: Name OR Postcode

Any Cheques MUST be made out in the name of "Grassroots Resources"


PO Box 484  Brighton SA 5048    08 8387 9993  info@grassroots.com.au   www.anglicantours.com.au

SPECIAL NOTE
Please send to Fr Max a digital copy of your passport plus a photo of yourself (Preferably not a boring passport photo) or Send by snail mail.