This year's form will be posted shortly, but let us know
ASAP if you plan to attend this program

To reserve your place:

F     Mail this form with your deposit;

F      If using a credit card, fax this form with credit card info;

F      Or, call (800) 663-8342 toll free.

r Germany Tour with “Med-Week”: Enclosed is my $595 CDN deposit

r Charge tour deposit(s) to my credit card.  r I am mailing my deposit(s).

r I have made airline reservations.   r I have (or have applied for) a passport.

r If available, I would like to share a twin room: Discount $115 CDN per Person
 

(Please print clearly – no doctor’s scrawl!)

Name                                                                                                                   

Address                                                                                                                

City                                  State/Prov.                     Postal Code                            

Office phone                                        Home phone                                               

E-Mail                                                 Fax phone                                                  

VISA or MasterCard credit card number                                                                 

Expiry date                       Name on card                                                                

Signature (Now you can scrawl)                                                                                 

If paying by credit card, you can FAX this form to (250) 490-3348 in Canada.

MAIL TO:     Occidental Institute Research Foundation (OIRF),
                    P. O. Box 100, Penticton, BC V2A 6J9 CANADA

For more information phone (800) 663-8342 toll free in North America,
                   Or (250) 490-3318 in Canada;
                   Weekdays, 8:30 AM to 4:30 PM Pacific Time.