Central America Registration

Registration Instructions

On-Line: Fill out the form below and click on the "Submit" button. Submit your $1,000 non-refundable deposit by phoning World Accord, in Waterloo (1-800-525-3545 or 519-747-2215) and charging it to your VISA or MasterCard.

By Mail: Fill out the form below and use the "Print" button on you browser to make a copy. Mail the form along with your $1,000 non-refundable deposit cheque to World Accord, 185 Frobisher Drive, Waterloo, Ontario N2V 2E6. Cheque should be made payable to World Accord - Build Tour Deposit.

Trip Selection/Travel Dates (place a checkmark in the box(es) next to the trip(s) you would like to go on)

2008/2009 Trips

Date	Location	Project	Status
November 1 -15	San Jose, Honduras	Kindergarten School	Open
January 17-31	Azugualpa, Honduras	Computer Centre	Full
February 7-21	Los Laurales, Honduras	Kindergarten School	Open
March 7-21	Chichoy, Guatemala	House	Open

	I would also like to travel independently in Central America before or after the Build Tour for approximately weeks
	I would like to make an intermediate stop on the way to or from Honduras

Personal Information

* Asterisk denotes a required field

Name as shown on passport (First & Last only)	*
First name you like to be called
Street Address
Address (cont.)
City
Province/State
Postal Code
Home Phone
Business Phone (if it is OK to call you there for urgent matters)
Email (if you don't have one, ask a friend)	*
Gender
Birth Date
If under 18, name of guardian traveling with you
Special dietary requirements
Name(s) of traveling companion(s)

Emergency Contact at Home

Name
Home Phone
Business Phone
Relationship

Skills

Spanish
Construction
Other Skills, (e.g. musical, photography, etc.)

Comments/Additional Information

Cost

Each trip costs $3,000/person including airfare (Toronto departure), billeting, food and transportation in Central America, and a contribution for construction materials. There may be additional costs for departures from other cities, airline fuel surcharges or late bookings that will be confirmed with participants prior to buying plane tickets.

Costs incurred for intermediate stops or trip extensions are additional.

$1,000 non-refundable deposit due with application

Balance due prior to travel

Agreements

	I will carry out-of-country medical insurance
	As a role model for the local people and a courtesy to other team members, I will abstain from consuming alcohol, tobacco and illegal substances during this trip.

If you would like more information,
email Richard Kirsh or
telephone 416-767-5837

If you prefer to send this by regular mail, use the Print button on your browser to make a copy