Cuba Cruise 2018

Santiago - Guantanamo July 20-28

Registration Form
If you are inclined to participate, please complete a form for each traveler as soon as possible and no later than April 30, 2019. Confirmation of particpation requires payment of a contribution of $150.

-- John McAuliff
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nationality
Passport number
Expiration date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Birth date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Birth place
Names of persons who will accompany you
Email
example@example.com
Phone Number

Area CodePhone Number
Level of interest
Accomodations in Santiago
If you prefer a double room, with whom?
Optional extensions

Other
I will contribute $150 to the Fund for Reconciliation and Development to confirm my participaton [On line at http://tinyurl.com/donateffrd By check to FFRD, 64 Jean Court, Riverhead, NY 11901]
Personal background (current or former occupation, special interests and skills, experience in Cuba, etc.)
Health or mobility issues, dietary requirements
Questions or comments
Should be Empty:

Santiago - Guantanamo July 20-28