PTAC Ministries Cruise Package Contact Information *Name: *Email: *Phone: Second Phone: *Address: *City: *State: —Please choose an option—ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY *Zip Code: Shore Excursion Selections *Number of People Traveling: *Please enter the first and last names of people traveling / show ages of children in parenthesis ( ): *Departure Date: *Destination: *Length of Vacation: —Please choose an option—OneTwoThreeFourFiveSixSevenEightNineTenElevenTwelveThirteenFourteenFifteenSixteenSeventeenEighteenOther All Inclusive: —Please choose an option—YesNo Car Rental: —Please choose an option—YesNo Please Provide Your Shore Excursion Information In The Following Field *On Each Line Please Provide Which Shore Excursion Your Interested In: (For Example: PORT / SHORE EXCURSION / COST) Please Enter Comments or Special Instructions Below: Please Enter the Numbers/Letters Below: