CatholicJourneys.com
PARTICIPANT APPLICATION

Please fill out this application completely and submit online. There is also an address below where you can submit your completed application by mail, if that is your intention. Either way, please follow-up with your deposit check for $600, or make your Secure Payment immediately online using your credit card. If you have any questions, please call CatholicJourneys.com:
(504) 834-4951 or (800) 715-6670
 
Program Number:
Departure Date (mm/dd/yy):
Your Preferred Departure
City/Airport:
   
Your Legal Name:
(as it appears in Passport)
First  
Last  
Title:
Preferred Name:
(if different than above)
Sex:
Birth Date (MM/DD/YYYY): Year:
Age at time of departure (Required)
Are You a US Citizen? YES NO
Passport Number:
Check here if you do not have a passport yet
Passport Expiration: Year:
Spouse, or Second Traveller's, Legal Name, if applicable (as the name appears in Passport):
First  
Last  
Second Traveller's Title:
Second Traveller's Preferred Name:
(if different than above)
Second Traveller's Sex:
Second Traveller's Birth Date (MM/DD/YYYY): Year:
Age At Time of Departure (Required)
Is the Second Traveller's a US Citizen? YES NO
Second Traveller's Passport Number:
Check here if the second travellor does not have a passport
Passport Expiration: Year:
Street Address:
(No Post Office Box Numbers)
City, State, Zip, Country:
City  
State  
Zip Code  
Country  
Home Phone:
Work Phone:
 
Your Email Address
(so we can contact you)
 
Do You Smoke? YES NO
Please try to match me with a Roommate,
or I want a single room (availability limited)
Roommate's Name (if known):
 
To ensure proper trip credit, please let us know how you heard about this trip: CatholicJourneys.com Web Site  
Group Leader / Administrator if so, which?
Spiritual Director or Chaplain if so, which?
Newspaper if so, which?
Radio if so, which?
Church Bulletin if so, which?
CatholicJourneys.com Newsletter or Promotional Mailing  
CatholicJourneys.com Staff Member if so, which?
Other Web Site if so, which?
Other: if so, which?
Travel Agents, please fill in the following:
Travel Agency Name:  
Contact Name:  
ARC / IATA #:  

A DEPOSIT OF $600 PER PERSON IS REQUIRED TO CONFIRM YOUR RESERVATION
Enrollment in and payment of your $600 deposit for the tour, constitutes your acceptance of all the Terms and Conditions for above mentioned trip.

You may mail a check for your $600 deposit (or Full Payment) per person to :

CatholicJourneys.com
5500 Prytania Street #234
New Orleans, LA 70115
800-715-6670

or call the office 800-715-6670 to charge it to a credit card.