REGISTRATION FORM - WASHINGTON, D.C. PERSONAL DATA OF PARTICIPANT/S Last Name: First Name: M.I.: Nickname: Passport No.: Expiration Date: Issuing Country: Street Address: City: State: Zip: Phone: Fax: Email: Birthdate: ACCOMPANYING PERSON/S: Last Name First Name M.I. Date of Birth Passport No. Expiration Date Issuing Country Hometown/Province: Company/Professional Affiliation: Last Visit to the Philippines: First time 1-3 years ago 4-6 years ago 7-9 years ago 10 + years ago ACCOMMODATION REQUIREMENTS (Basic Tour: July 11 - 14, 2012) I am joining the tour and will pay the full Basic Tour Package rate as indicated below, which includes my hotel stay with daily buffet breakfast; choice of Special Tours or Immersion Programs; and the meals and activities indicated in the ACGTD flyer. I understand the round trip international air fare is NOT included in these amounts. I want to be: (please tick the applicable box) 4D/3N 5D/4N c Alone in a room (Single) $782.00 $932.00 Prevailing air fare to be added at c Share a room with one (1) other participant designated by the organizers (Twin) $557.00 $632.00 time of full payment. Please call for details c Share a room with two (2) other participants designated by the organizers (Triple) $547.00 $618.00 Sharing a room with: Date of return: SPECIAL TOURS A or IMMERSION PROGRAMS - July 11, 2012 (Wednesday) Choose one (1) only; pre-registration required. Philippine Jaycees (Hosted. Departs Hotel at 1:00PM) Corregidor Tour (Additional $50 per person applies. Departs Hotel at 7:15AM) Manila City Tour (Included. Departs Hotel at 1:00PM) Gawad Kalinga Orientation & Build (Hosted.Departs Hotel at 8:30AM) Museum Tour (Entrance Fees apply. Departs Hotel at 1:00PM)) Visita Iglesia [Metro Manila churches] (Included.Departs Hotel at 9:00AM) Property Developers' Open House (Hosted. Departs Hotel at 1:00PM) TV & Shopping Special (Entrance Fees may apply. Max. of 50 pax only. Departs Hotel at 9:00AM) Alabang Tech & Business Tour (Hosted. Departs Hotel at 1:00PM) SPECIAL TOURS B - July 13, 2012 (Friday) Choose one (1) only; pre-registration required. Departs from Malacanang after the luncheon. Manila Ocean Park Spa Experience at Wensha (Service Fees may apply) Central Bank Museum Gold Collection OPTIONAL POST TOUR - July 14 to 17, 2012 (Limited slots available for each Tour. Reservation on first-come-first-served basis only.) Twin* Twin* Twin* Aklan-Boracay 4D/3N $436.00 Laoag-Vigan 4D/3N $345.00 Dive Package** 3D/2N $559.00 Cebu - Bohol 4D/3N $579.00 Legazpi (Bicol) 4D/3N $478.00 2-Round Golf Package 3D/2N Please call Davao 4D/3N $520.00 Puerto Princesa 4D/3N $399.00 Tagaytay Tour & Spa 3D/2N Please call Iloilo-Bacolod 4D/3N $543.00 * Airfare, if applicable, and other personal charges NOT included. Single supplement and triple sharing available. ** Must be certified to dive. Dive certification course available at $300.00 per person. Rates are subject to change until fully paid. Deadline for registration and final remittance of payment is May 23, 2012. A non-refundable deposit of $500.00 for each participant is due upon submission of this form to reserve your space. Passports must be valid for at least 6 months on date of departure from the US. It is recommended that participants purchase travel insurance. EXCLUSIONS: The rates for the Basic Tour Package do not include gratuities; optional tours; meals not listed in the flyers; travel insurance; Philippine travel tax (if applicable); airport terminal fees; and other incidental expenses. Additional charges may apply if paying by credit card. Please fax or email your Registration Form to: I understand the organizers will be sending me Form B -Payment Notification Form to Cultural Section - Philippine Embassy accomplish and my participation is only confirmed when I have completely submitted 1600 Massachusetts Avenue, NW, Washington, D.C. 20036 all required documents and fully paid the tour fees. Email: Tel: (202) 467-9398/9378 Fax: (202)467-9417 Signature/Initials: [email protected] Please send your payment to any of the following participating travel agencies of your choice: Alpha Travel - 301.908.6788, [email protected]; Capricorn - 703.542.2962; [email protected] Date: Travel House - 301.460.7320; [email protected] Travel Outlet - 757.424.3311, [email protected]; Travel Wise - 301.248.8898; [email protected] World Tours - 703.821.0840; [email protected].