Fund for Reconciliation and Development
64 Jean Court, Riverhead, NY 11901
director@ffrd.org
917-859-9025
April 2025
50th Anniversary of the end of the war
The current draft itinerary and cost estimate is here
https://vnpeacecomm.blogspot.com/2024/07/draft-itinerary-for-50th-anniversary.html
Bracketed [Dates] below are supplemental to the core program and not included in estimated costs..
After completing the form for each traveler, click on "submit" at the end.
If you have any difficulty, or do not receive a confirmation,
be sure you have the latest version of Adobe Acrobat in your computer.
Please submit this registration form as soon as you are able to confirm your plans, but no later than February 15, 2025.
The group is limited to 25 persons. Additional registrants will be wait-listed.
How do you plan to participate
[arrive on April 12 or 13 for excursion to Ha Long Bay]
[arrive in advance for personal time in Ha Noi area]
Core Viet Nam program April 15 - May 1 departure
[May 1 extra day to visit Cu Chi Tunnels, Cao Dai Temple]
[May 1 extra day to visit Cu Chi Tunnels, Mekong Delta]
[Visit Cambodia May 2 - 7]
[Visit Laos May 7 - 10]
Other
Full name as on passport
*
Passport number
*
Country of issue
*
Date of expiration
*
Birth place
*
Date of birth (month/day/year)
*
Gender on passport
*
male
female
Current mailing address
*
Phone number(s)
*
e-mail address
*
Emergency US contact, phone number, and relationship
*
Room preference:
*
single
double
If double, name of person sharing:
Room environment
non-smoking
smoking
Occupation, employer, position/title (former primary work, if retired):
If you have previously visited Indochina, approximately when:
Primary personal and/or professional goals for this trip:
*
Optional: Special skills for cultural exchange opportunities:
If applicable, please describe your involvement in the movement against the war in Indochina, for normalization of relations and/or addressing war legacies (for sharing with the group and with hosts).
Please summarize your work and social/political activism since the anti-war movement (for sharing with the group and with hosts)
Special medical, mobility and dietary requirements
Comments, questions, itinerary suggestions, requests for counterpart introductions, etc.:
As a confirmation of interest and for administrative support, make by February 15 a contribution of $200 to the Fund for Reconciliation and Development here https://tinyurl.com/donateFRD The contribution is 50% refundable if you need to withdraw before March 15th.)
*
already done
will do by February 15
sending by mail to FRD, 64 Jean Court, Riverhead, NY 11901
Other
I am sending as a scanned or photo attachment the data/picture page from my passport (to director@ffrd.org)
*
today
within a week
as soon as I receive a new passport
FRD is facilitating and coordinating this trip in cooperation with the Viet Nam - USA Society, but is not a travel agent or tour operator.
I agree that FRD is not responsible legally for this trip
I have or will obtain travel insurance for medical, trip cancelation and other coverage.
My meals must be
vegetarian
vegan
Submit
Should be Empty: