June 10-17, 2016

Registration Form

Register online here, or print this Registration Form
and mail to:
Mount Tabor Centre
PO Box 700
Orleans, MA 02653

CONTACT INFORMATION

Your name exactly as it appears on your passport:
Mailing Address:

Telephone:
Email:

The following information is now required by the US government. This information must agree with your passport.

PASSPORT INFORMATION

Passport #: Please call 508-240-7090 with this #.
Date of issue:
Date of expiration:
Date of Birth:
Place of Birth:
Gender: MaleFemale

ACCOMMODATIONS

Price is based on double occupancy
I will share a room:

I will share a room with:

Number of beds in room:
2 beds1 bed1 or 2 beds OK

Please arrange for a same-gender room-mate:
YesNo

I prefer a single room*
YesNo
*A supplementary fee for single room to be determined

Please register online or print the Registration Form, complete and mail with Deposit to:
A Week with St. Benedict
Mount Tabor Centre
PO BOX 700
Orleans, MA 02653