Booking Request

Tour Name*:

Email Address*:

Departure City*:

Departure Date*:

No. of passengers

No. of Rooms*:

Title*:

Passenger Name Room 1*:

Room Type*:

Hotel Type*:

Credit Card Owner

Title:

Companion:

Title:

Companion:

Title:

Companion:

Amount due, $

Title*:

Credit Card Owner*:

First Name as in Credit Card*:

Last Name as in Credit Card*:

Billing Address*:

City*:

Postal Code*:

Country*:

Telephone*:

Type of phone*:

Credit Card Type*:

Credit Card Number*:

Security number*:

Expiration Date*:

Please note: Deposit of $250 per person is due now. Balance is due 60 days before departure or upon confirmation if less than 60 days.

Insurance: We strongly recommend the purchase of cancellation and/or medical Insurance. Would you llke more details? Yes No

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