| Date of Tour:
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Date Reservation Taken: |
| Time of Tour:
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Date Form Mailed: |
| Organization:
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Phone: Cell: |
| Contact Person:
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Email: |
| Address:
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City: |
| State:
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Zip: |
| Maximum number anticipated for tour:
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Length of time on site (based upon maximum number anticipated): |
| Tour Fee:
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Docents available: |
| Group Information: | |
| Type of Group (circle appropriate) : | Adults Seniors Children Family Other |
| Special Requirements (circle appropriate): | Wheel Chair Difficulty in Walking Hearing ImpairedVisually Impaired Other |
| Transportation (circle appropriate): | Bus Van Auto How many vehicles? |
Remember:
If you feel that you are not going to arrive on time, the tour
My signature indicates I have read and agree to the terms and
Signature: _____________________________________________ Date: __________________________________________________
Complete, sign and return a copy of this form to: CCHS
We look forward to your visit to the Cumberland County Historical Society. |