Reservation Form

 Pilgrimage Information:
Departure Date
Destination
Departure City/Airport

 Reservation Made By:
First Name *
Last Name *
Address *
 
City * State *  Zip *
Telephone
Fax
E-Mail *
How did you hear about us? 

 Pilgrimage Options:
Private Room in Medjugorje $175
Private Room in Frankfurt $125
Travel Insurance Quote Yes
Business Class Upgrade One Way   $1,750
Business Class Upgrade Round Trip $3,500
Interested in Rome Extension $1,099

 Passenger Information:
All accommodations assume two persons per room. If you are traveling alone we will pair you up with someone else traveling alone.
If you prefer a private room, check the "Single" box. The additional cost for this pilgrimage is $175.00

Number of Travelers

Emergency Contact Information

In Case of an Emergency please provide us with a name, phone number, and email address of someone we can contact.

Name: *                     Phone: *
Email:
*


Enrollment in the tour constitutes your acceptance of the program Terms and Conditions.

Once your Reservation Form is received we will check flight availability, and confirm the total cost of your pilgrimage within 24 hours (excluding weekends).
If you wish to confirm we will provide you with payment details. Please contact us if you have any questions.




Medjugorje Web 772 N Peace Rd. DeKalb, IL 60115
877.Web.Medj (932-6335)
815.333.2338 Fax
Email: sshawl@medjweb.com