Tour Information Required (Israel Feb/Mar Tour 2018 0r 2019) or (Vietnam Tour leaving October 3rd 2017)
or India Tour 2018/2019 (Month will depend on the group going)

Please fill in one form per person. We also require you to email a jpg or pdf of your passport.
Alternatively you can send a copy to Fr Max Bowers, PO Box 484 Brighton. SA 5048.

Surname (As per Passport) The name and spelling MUST be exact.
Christian Name(s) as per passport
Preferred name to be called
Address including post code
Email Address
Phone Home Mobile
Passport Number
Date Passport Expires
Date of Birth
Birth City(as per passport) City where you were born
Nationality on Passport
Frequent Flyer details (If you are a frequent Flyer card holder)
If married and partner still alive, wedding anniversary date
Contact person while you are overseas - Name/Address/phone
Contact relationship to you
Other Info

Smoker Yes    No

Vegetarian Yes    No

If you have any special dietary requirements for meals, please indicate here.
Sleeping arrangements

Single beds (Two to a room)

Double bed (Normally a queen size)

Single room accommodation
(Additional cost $1300 - Israel Tour, $970 for Vietnam/Cambodia tour)

I wish to share a room with...

I wish to share with

I have no preference and happy to share with anyone

Add Capital city you will be leaving Australia from.
Airline information

I/We are returning with the group
I/We are considering staying longer or travelling on to Europe or other locations.

Travel Insurance I understand this is my personal responsibility and the company I use is my own choice. Anglican Tours can offer suggestions if asked.
Refunds I understand that the deposit is non refundable from ANGLICAN TOURS and should you need to cancel, the 'possible' refund would be a matter between yourself and the insurance company you select. I agree to this.
Give details of any medical background that may be useful if you need medical treatment in Israel.
How did you come to hear about this tour?

Direct Money Transfer Details
ANZ Bank
BSB: 015 259, Account 304976571
Make sure you add your name to identify a payment.
If paying by cheque, cheques need to be made out to “Grassroots Resources"

All Cheques MUST be made out in the name of "Grassroots Resources"

PO Box 484  Brighton SA 5048    08 8387 9993

SPECIAL NOTE - Please send to Fr Max a digital copy of your passport plus a photo of yourself (Preferably not a boring passport photo) or Send by snail mail.