JEWISH HERITAGE TOURS
AHAVATH TORAH INSTITUTE / TOURS DIVISION

2624 Avenue R, Brooklyn, N.Y.  11229-2502
1-888-253-9167  or  (917) 753-5178  or  (514) 924-9447
Fax: (718) 382-0648   Email: jewisheritagetours@hotmail.com

Please reserve space(s) for me/us on your upcoming trip to:

Shavuoth Vacation – June 6 to 11, 2008

[      ]   3-Star Maremonti Residence:  $1899  (50 m from hotel)

[      ]   4-Star Residence:  $2199  (across the street from hotel)

[      ]   Hotel: $2399

Prices are in USD, are pp/do, and include hotel stay, air and hotel transfer, taxes and gratuities. Does not include any tours or airport transfer.

Personal Information

Mr.   Mrs.   Ms.   (circle one) Name:  ____________________________________________________________

Address:  __________________________________________________________________________________

__________________________________________________________________________________________

City:  _________________________  State:  _________  Zip Code:  ___________

Daytime Tel.: ( ______ )  _____________________     Evening Tel.: ( ______ )  _____________________

Passport Information

Passport Number(s): ___________________________ Country of Issue: ____________

Expiration Date: _____________________   Date of Birth (mm/dd/yyyy): ____________

Trip Options (please check all that apply)

[      ]   I wish to share a room with _________________________________________
[      ]   I am travelling alone, but prefer a roommate. I understand that if one is unavailable, I must pay a supplement.
[      ]   I prefer to dine with: ___________________________________________________________
[      ]   I have these dietary requirements: _________________________________________________

Please make your checks payable to: Ahavath Torah Institute

Travel insurance is strongly recommended. 

Credit Card Authorization

Name: (as appears on card)   ______________________________________________

Address:  __________________________________________________________

City:  _________________________  State:  _________  Zip Code:  ___________

I,  ______________________________ , hereby authorize the following charges to Ahavath Torah Institute:

Amount in $ US: __________   Card Kind:   [      ] VISA    [      ] MasterCard    [      ] American Express

Card number: __________________________________________   Expiration Date: _______________

Signature:  ______________________________________

Where did you hear about us?

[      ]   Newspaper ___________________________________________________

[      ]   Internet ______________________________________________________

[      ]   Mailing        [      ]   Word of Mouth      [      ]   Other  __________________

ASSUMED RESPONSIBILITY

I hereby agree to the Terms and Conditions of Assumed Responsibility (available in full on website at http://www.ahavathtorah.com/tour/2008-Shavuoth-frm.htm#AssumedResponsibility). If the application is made for, or by a person under 21 years of age, both parents or the applicant's guardian must also sign the application.

Date: _____________    Signature of Applicant(s): _____________________________________