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Convention Form

101^st Annual Lions Clubs International Convention
June 29 - July 3, 2018 at Las Vegas, Nevada, USA

(To be filled by each delegate)

Name as per Passport Mr./Mrs./Ms *

Complete Mailing address

Contact Numbers

Landline :

Mobile *:

Email *

Passport Details :
Passport No.	Date of Issue	Date of Expiry	Place of Issue

Date of Birth

Sex

Male

Female

Meal Prefrence

Vegetarian

Non-Vegetarian

Room Preference

Double Share

Triple Share

Four Share

Package Type

Classic

Grand

Tour Program Booked (Please tick the package you have opted for)

	Package A: Convention only (4 Nights / 5 Days)
	Package B : Convention + West Coast USA (6 Nights / 7 Days)
	Package C : Convention + Grand USA (12 Nights / 13 Days)
	Package D : Convention + Miami + Orlando (9 Nights)
	Package E : Convention + Alaska Cruise (12 Nights / 13 Days)
	Package F : Convention + Canadian Westurn Vistas (10 Nights / 11 Days)

Club Name

Club No.

Membership No.

District

Position in Club / District

1.	Enclosing DD/Cash/Cheque No. Favouring Shaan World Travels payable at New Delhi for Rs. 40,000/- as Booking amount for tour package.
2.	Enclosing DD/Cash/Cheque No. Favouring Shaan World Travels for Rs. 16,500/- against non refundable USA visa application fee and VFS service fee including bank charges.
3.	Enclosing DD/Cash/Cheque No. Favouring Shaan World Travels for Rs. 12,500/- against non refundable Canada visa application fee and VFS service fee including bank charges.
4.	I acknowledge that I have read the terms and condition, understand, and agree to the payment policies and procedures of this package for attending the 101st Annual Lions Clubs International Convention at Las Vegas, Nevada, USA.

Date

Signature of the Travller

NOTE : In case if you are sending payment through bank transfer or depositing cash payment In our account please note the bank details and send scan copy of deposit slip or bank transfer details with booking form :- A/c Name: SHAAN WORLD TRAVELS, A/C No.: 034305002655 Bank ICICI,Branch: Connaught Place II, KG Marg, New Delhi, RTGS/NEFT/IFSC:ICIC0000343

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