Please fully complete the following application in order to register for one of our many wonderful trips.   You may also complete this form and mail or fax (480-945-0691) it to our office. 

If you experience any difficulties submitting this form you may e-mail the form to us by completing the form and going to:  'file'  →  'send' →  'page by e-mail' 

(e-mail to ariel@mishkaproductions.com). 

Reservation Made By

TOUR INFORMATION

   I will also join the 3 night Post Tour to FLORENCE $899

   I will also join the 3 night Post Tour to ROME $999

PASSENGER INFORMATION (Names MUST Be Exact Match to Your Passport)

Title

First Name

Middle Name

Last Name

I prefer to be called

Birthday (MM/DD/YY)

Address

Address 2

City, State, Zip Code

Country

Home Phone

Work/Cell Phone

Fax

E-Mail

Passport #

EMERGENCY CONTACT

REGISTRATION OPTIONS

SPECIAL REQUESTS

:::  ADDITIONAL COMMENTS OR INFORMATION  :::

PAYMENT INFORMATION

A $500 per person deposit is due at the time of booking.

Payment in full is required at the time of booking if you are registering with in 60 days of departure. 

A $50 late booking fee is applied for bookings made with in 30 days of departure.

  I wish to make a direct credit card payment (only possible if more than 60 days prior to departure)
       Name on Credit Card 

 
       Type of Card        Visa       Master Card       American Express  
 
       Card Number    Exp. Date

 
         Charge the $500 per person deposit now
         Charge the $500 per person deposit & insurance now
         Charge total trip costs

  I wish to make my payment via Check or Money Order. I will send my payment by mail.

       If paying by check mail to:  Mishka Productions, PO Box 6547, Scottsdale, AZ 85261

Enrollment in and/or payment for any Mishka Productions/206 Tours trip or service

constitutes your unconditional acceptance of all applicable Terms & Conditions .

  Initial Here to agree to all Terms & Conditions

You may also print this form, complete it and fax it to us at 480-945-0691