Divina Sicilia

www.divinasicilia.com

A Culinary Tour of Sicily

Reservation Form:

Total cost for culinary tour : €1,900 ($ 2,500) per person (double occupancy) Includes everything as listed in the tour itinerary. Transfers from and to Palermo airport are included on only the opening and closing dates of the tour. Single room supplement available at €380 ($500). Air Fare is not included.

Name: (as it appears on your passport):

Last:______________________ First:______________________ Middle:______________________

Passport #: _________________ Date of issue: _________________ Place of issue: ______________

Home Address: _____________________________________________________________________

City:____________________________ State: _________________________

Country: ________________________ Zip/Postal code: ________________

Home Phone: _______________________ Business Phone: _________________________

E-mail address______________________________________________________________

You will be traveling with_____________________________________________________

Would you like to be matched up with a roommate? YES_____ NO_____

In case of emergency, notify: ___________________________________________________

Phone: __________________________ E-mail address: _____________________________

Signature of the person you are traveling with (if any)________________________________

Your signature_______________________________________________________________

Please mail or fax completed and signed registration form to:

DIVINA SICILIA

In care of: Vincenzo Clemente

Via Villa Heloise, 42

90143 Palermo, Italy

Phone: 011.(0)39.091.612.4095

Fax: 011.(0)39.091.300988