Applying for the Royal Rajasthan Fundraising Adventure Trip   Yes    No

Would you like to receive a letter of acknowledgement for your donation?  Yes    No

First Name        Last Name 

Email Address

Mailing Address

City

State/Province

Zip/Postal Code 

Country

Phone (include country code)

Gender   Male    Female

Date of Birth MM/DD/YYYY

Level of Physical Fitness   Above Average (exercise regularly)                Average

                                        Below Average (do not exercise regularly)      Poor

First Choice Departure Date MM/DD/YYYY

Second Choice Departure Date MM/DD/YYYY

Hotel Accommodation   Single    Double (Twin Beds)    Double (Double Bed)

Meal Preference   Vegetarian    Non-Vegetarian