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General Information
Name*
First Last
Organization*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Home Phone*
Work Phone
Fax
Email*
Departure Information
Departure Date*
Departure Time*

: HH

MM
Departure Location*
Destination*
Number of People*
Return Information
Return Date*
Return Time*

: HH

MM
Return Location*
Additional Information
Will there be alcohol on the bus?
- Yes
- No
Would you like Shafer to help you with:
- Tickets
- Meals
- Attractions
- Lodging
What else do we need to know to make your trip a success?

General Information