Anir Experience - Program Deposit Form

After receiving your deposit, we will email you a full registration form, additional

information, and instructions.

Make checks or money order out to: Anir Foundation and mail to:

Anir Foundation 1297, Dark Hollow Road, Alderson, WV 24910.

anirexp@gmail.com

If you would like to use a credit card (we accept all major USA credit cards) we

can email you a form. Please note there is a 4% additional bank charge. If you

wish to use Venmo there is a 2% service charge. We do not accept PayPal.

Check which Program You wish to sign up for:

15-day____Cape Town Community participation May 16 – 31, 2024 - $3958 per-person, for two persons

sharing, if single room $4058 per-person.

10-day____Cape Town Cultural program May 16-25, 2024 - $3390 for two persons sharing, if single room

$3640.

___ Add-on Full-day Safari (scheduled the day after the end of your Cape Town Experience) includes

transportation to and from safari park, lunch and game drives.

Deposit - $500, due with this form, fully refundable until January 31, 2024. No refunds, for

any reason, after January 31, 2024.

Full payment due February 10, 2024 (deposit is deducted from full cost). Payment after

February 15 will reflect a $200 USD increase.

Please Print Legibly

Name First ________________________________________ Middle or Maiden _______________________________

Name Last ________________________________________ Preferred Name________________________________

Date of birth ___________________________________

Day Phone _________________________________ Evening Phone ______________________________

Cell _______________________________________ E-mail _____________________________________