Ukpaymentform2014

Payment Form Master Rug Cleaner, UK 2014 Carpets, Castles and Cathedrals May 16-25, 2014 Master Rug Cleaner 3907 Ross Ave. Dallas, TX 75204 214/821-9135 (Ellen), 443/562-5714 (Aaron), 214/821-9136 (fax, Ellen) Name: ______________________________ Second Person ______________________ Company: _______________________________________________________________ Mailing address: __________________________________________________________ City: ____________________________ State/Province_________ Postal Code:_______ Telephone: __________________________________Fax: _______________________ Mobile Phone: _______________________________ E-mail: _________________________________________________________________ PAYMENT OPTIONS: The price is $3800.00 single occupancy. Double-occupancy, first person $3800 , second person $3200. Includes ground transportation within the UK and most meals. Each traveler is responsible for airfare to and from London Heathrow, transportation from Heathrow to the hotel in Windsor and transportation back to Heathrow. ďƒ° ďƒ°

Two people sharing a room Single room

1

Make check payable to:

Master Rug Cleaner 3907 Ross Avenue, Dallas, TX 75204 Payment Due in Full By April 1, 2014

Non-refundable deposit of $1,000 is due with the application by check or credit card.

Refund Policy: In the event that you have to cancel your trip due to unforeseen circumstances, we offer the following trip cancellation policy. We recommend travel insurance for unexpected travel cancellations, medical emergencies and baggage loss.

Information on travel insurance is provided below.

1. Notice of trip cancellation received on or before April 1, 2014 is subject to a cancellation fee of $1,000.00.

2. Notice of trip cancellation received April 2-15, 2014, is subject to forfeiture of 40% of the total trip package.

3. Notice of trip cancellation received after May 1, 2014, is subject to the forfeiture of 100% of the total tour package price.

Trip Insurance (optional, but recommended): MH Ross; 1-800-423-3632 www.mhross.com Paid Directly to MH Ross Master Card, Visa or AMEX

Expiration date: __________________

Card Number: ____________________________________________V-Code_________ Name on Card: __________________________________________________________ Credit card billing address (if different from above): ________________________________________________________________________ ________________________________________________________________________ Total Payment: $_____________

Affiliation: Master Rug Cleaner ___ Association of Rug Care Specialists ___ Both ___

2

Emergency Contact: Name: ___________________________________________________________ Address: _________________________________________________________ City/State: ________________________________________________________ Phone: ___________________________________________________________ Email: ___________________________________________________________

Date: __________

Applicant Signature: ______________________________________________________

Additional Applicant Signature: _____________________________________________

3