Tour Booking Request Passengers

Booking Request

Program Name

Email Address

Departure City

Departure Date

No. of Passenger

No. of Rooms

Passenger Details

Title

Passenger Name Room 1

Room Type

Hotel Type

Credit Card Owner

Payment Details (to use credit card please select Credit Card Owner)

Credit Card

Amount due:

Title

Credit Card Owner

Name as in Credit Card

Billing Address

City

Postal Code

State/Province

Telephone

Type of Phone

Select Credit Card Type

American Express Master Card Visa

Credit Card Number

Security Number

Expiration Date

Promotional Code

I agree to the credit card payment condttions.

Important notices

Please note: Deposit of $100 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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