MOTORCOACH TOUR RESERVATION FORM

NAME:______________________________________________________________________

ROOMMATE’S NAME: __________________________________________________________

ADDRESS:___________________________________________________________________

PHONE:_____________________________________________________________________

TOUR TITLE AND DATE:________________________________________________________

TOUR COST:____________________

PAYMENT METHOD-

(CHOOSE ONE) ___CASH       ___CHECK OR MONEY ORDER made payable to Outta Here! Travel

___CHARGE (make sure to call and see if credit card is accepted for the tour)

___VISA                        CARD # __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

___MASTERCARD                   EXPIRES __ __ / __ __

                                       3 DIGIT SECURITY CODE __ __ __ (on back of card)

__YES, I HAVE READ THE “FINE PRINT”

  Signature _________________________ (APPLIES FOR CHARGES AS WELL) Date _________________

OUTTA HERE! TRAVEL-PO BOX 31-OXFORD, WI 53952

608-268-5718/TOLL-FREE-866-593-1313/FAX-608-268-3428