MOTORCOACH TOUR RESERVATION FORM
 print out and mail to Outta Here! Travel

NAME:______________________________________________________________________

ROOMMATE’S NAME: _________________________________________________________

ADDRESS:___________________________________________________________________

PHONE:_____________________________________________________________________

E-MAIL: _________________________________________________________

TOUR TITLE AND DATE:________________________________________________________

TOUR COST:____________________

PAYMENT METHOD-

(CHOOSE ONE) 
___CASH 
___CHECK/MONEY ORDER payable to Outta Here! Travel 

___CHARGE (make sure to call and see if credit card is accepted for the tour)

___VISA                    CARD # __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

___MASTERCARD    
___DISCOVER               EXPIRES __ __ / __ __

___AM EXPRESS                  SECURITY CODE __ __ __ ___ (on back of card)

__YES, I HAVE READ THE “FINE PRINT”

Signature _________________________ (APPLIES FOR CHARGES AS WELL)

 Date _________________

 
OUTTA HERE! TRAVEL-PO BOX 31-OXFORD, WI 53952
608-268-5718/TOLL-FREE-866-593-1313/FAX-608-268-3428
WWW.OUTTA-HERETRAVEL.COM           BRENDA@OUTTA-HERETRAVEL.COM