Rotary & AISU Mexico Trip May 30-June 6, 2018
Thank you for joining us on our trip to Mexico! Please carefully fill out the following info.
First legal name (as it appears or will appear on your passport-- this will be used to purchase your flight)
Your answer
Middle legal name (as it appears or will appear on your passport-- this will be used to purchase your flight)
Your answer
Last legal name (as it appears or will appear on your passport-- this will be used to purchase your flight)
Your answer
M/F
Birthday
MM
/
DD
/
YYYY
E-mail address
Your answer
Phone number (xxx-xxx-xxxx)
Your answer
Shirt size (adult unisex)
Street address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Are you a US citizen? If not, we will be in touch with you about visa/passport questions.
Passport number (if you don't have your passport, put NA. You'll need to get one before Jan. 1 by clicking here: http://slco.org/clerk/passport)
Your answer
Passport expiration date (if you don't have your passport, put NA. You'll need to get one before Jan. 1 by visiting here: http://slco.org/clerk/passport)
Your answer
Beneficiary first & last name (for insurance purposes --- usually spouse or parent)
Your answer
Beneficiary's e-mail address
Your answer
Beneficiary's phone number
Your answer
Emergency contact's first & last name (for use on international trip)
Your answer
Emergency contact's phone number
Your answer
Emergency contact's e-mail address
Your answer
Emergency contact's relationship to you
Your answer
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