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PHS Travels to Long Island
July 21 - 24, 2008

Please PRINT OUT and mail this form and a $300 per person deposit check (payable to JL Tours):

JL Tours, 725 Hollow Road, Radnor, PA 19087

Full Name(s)
Preferred Salutation(s)
Street
City State Zip
Home Phone Work Phone
Email
Roommate

Accommodation (please check): ____ Willing to Share    ____ Single

I/we have read the Responsibility Clause and agree to all the conditions therein.
Signature Date
Signature Date

 

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