Name: __________________________
Address: ________________________
City: ___________________________
State, Zip: ______________________

Telephone:
day _____________________________
evening __________________________
E-mail: ___________________________

Please reserve the following spaces:

#____ Round Trip to Portland, OR

#____ One Way- Washington to Portland

#____ One Way- Portland to Washington

Total amount: _______________________

PAYMENT METHOD:

______Check payable to:
Washington DC Chapter, NRHS
minimum 1/3 of fare

____ Charge to my Visa/Mastercard
$______________ (Minimum of 1/3 of the fare)
Card No.: ______________________ Expiration Date: _________
Signature: ______________________________________

NAMES OF ALL PASSENGERS (REQUIRED):

-------------------------------------------------------------------------------------------------------

BOARDING LOCATION:
____ Washington DC      ____ Portland
____ Other: _______________________________________________

EARLY BIRD DISCOUNT!
Make your reservation and payment by March 31, 2005 and deduct three hundred fifty dollars ($350.00) per person round trip, or one hundred fifty dollars ($150.00) per person for one way fares! Payment must be made by cash, check or money order for this offer. Early Bird discount applies only to round trip and one way fares between Washington and Portland. For information, call 610-429-5858 or e-mail to dover.agent@dcnrhs.org .

Mail to:
WASHINGTON DC CHAPTER NRHS
c/o Mike Martin, Reservations Agent
503 Mayfield Avenue
West Chester, PA 19380-5211