TOUR RESERVATIONS FORM

National Trust for Historic Preservation
Mark Twain's Mississippi, July 11-19, 2007  NTMT - Literary Traveler

Please complete the traveler information below. A deposit of $1000 per person is required to reserve a place on the Delta Queen. Deposits may be made by credit card or check.
Visa [  ]  MasterCard [  ]

Card Number: ______________________ Expiration Date: ___________________

______________________________ ____________________________________
Name as it appears on credit card (please print) Signature

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Name #1                                                                                        Date of Birth

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Name #2                                                                                        Date of Birth

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Street Address ---- City ----- State ----- Zip Code

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(Area Code) Daytime Telephone --- Evening Telephone

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Fax                                                          Email

Accommodations:

Cabin Preference: 1st Choice: __________ 2nd Choice:  ______________

Single Applicants Only:

[ ] I prefer single accommodations.
[ ] I plan to share accommodations with: ____________________________________
[ ] Please arrange a share for me (not guaranteed).
[ ] I am a smoker [ ] I am a non-smoker

National Trust Study Tours are open to members only. If you are not a member of the National Trust,  please enclose a separate check with this form payable to the National Trust for Historic Preservation for a one-year membership as follows:

[ ] $20 individual [ ] $24 family
I (We) are National Trust members. My/our membership number is ___________

[ ] I/ We have read the terms and conditions for the trip and agree to them

______________________________________________________________________
Signature ----- Date                                             Signature ---- Date

Please send the completed reservation form to: National Trust for Historic Preservation, STUDY TOURS, c/o Bank of America, P.O. Box 320, Washington, D.C. 20055-0320. Or you may fax your reservation to NATIONAL TRUST STUDY TOURS at the following number:

Fax : (202) 588-6246

 

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