Reservation Form

 Pilgrimage Information:
Departure Date
Destination
Departure City/Airport

 Reservation Made By:
First Name *
Last Name *
Address *
 
City * State *  Zip *
Telephone
Fax
E-Mail *
How did you hear about us? 

 Pilgrimage Options:
Land Only (No Flights) $995
Travel Insurance Quote Yes

 Passenger Information:
All accommodations assume two persons per room. If you are traveling alone we will pair you up with someone else traveling alone.
Number of Travelers
Emergency Contact Information

In Case of an Emergency please provide us with a name, phone number, and email address of someone we can contact.

Name: *                     Phone: *
Email: *

Enrollment in the tour constitutes your acceptance of the program Terms and Conditions.

Please contact us if you have any questions.
Medjugorje Web 772 N Peace Rd. DeKalb, IL 60115
877.Web.Medj (932-6335)
815.333.2338 Fax
Email: sshawl@medjweb.com