ADDRESS____________________________________________________________________________________

(STREET, CITY, STATE, ZIP)___________________________________________________________________

PHONE: (HOME)_________________(WORK)_________________e-mail_______________________________

DEPARTURE CITY/AIRPORT:__________________________________________________________________

SMOKER? YES_____ NO_______ CITIZEN OF (COUNTRY) ____________________________

PASSPORT NO.__________________________________ EXPIRATION DATE__________________

COUNTRY OF ISSUE__________________ PLACE OF BIRTH_________________________________

DATE OF BIRTH______________________DISABILITIES________________________________________

Please check hotel/cruise rooming preferences:
                  [   ] DOUBLE ROOM WITH ________________________________________
             or [   ] DOUBLE ROOM (YOU PICK MY ROOMMATE)

PAYMENT METHODS:

1) CHECKS PAYABLE TO:
FUTURE TRAVEL, INC., 1085 HERCULES, HOUSTON, TX 77058 USA
PHONE: (800) 929-9004, PHONE: (281) 480-1988, FAX: (281) 480-2587

2) CREDIT CARDS: Prices are cash discount; add 3% for credit card.
Complete online credit card authorization form to be printed, completed, and faxed to Future Travel.

3) IF OUTSIDE THE USA pay by any of the following: a) A CHECK MADE OUT THROUGH A US BANK; b) MONEY ORDER; OR c) wire transfer to HORIZON CAPITAL BANK , WEBSTER, TEXAS USA SPECIFYING ACCOUNT #047182, ROUTING #113023945. YOU MUST ADD $20.00 TRANSFER FEE CHARGE.