Booking Form Tour Name * —Please choose an option—'Stan's' of the Silk RoadEuropean River Classic CruiseJapan 18-35'sSpain, Portugal & FranceGreece, Turkey & The MedWonders of Sri LankaCanada & Alaska Cruise/TourOther (Please specify below) Departure Date * April departureSeptember departure Departure Date * May departureOctober departure Departure Date * June departureAugust departure If 'Other', please type your tour name here: Number of Passengers * 12 Passenger 1 Full Name * Title * Preferred First Name * Date of Birth * Nationality * Passport Number * Passport Issue Date * Passport Expiry * Phone * Email * Passenger 2 Full Name * Title * Preferred First Name * Date of Birth * Nationality * Passport Number * Passport Issue Date * Passport Expiry * Phone * Email * Address Street Address Suburb City Country Postcode Accommodation Information Accommodation Preference Double BedTwin ShareSingle Room If sharing, who would you like to room with? Upgrade Flights? NoPremium EconomyBusiness Would you like to discuss a travel extension? YesNo Emergency Contact Name * Relationship * Phone * Airline & Travel Information Passenger 1 Aisle or Window AisleWindow Medical Conditions Special Dietary Requirements Passenger 2 Aisle or Window AisleWindow Medical Conditions Special Dietary Requirements Travel Insurance Required? YesNo If you have selected No, please provide details of your insurer below. Travel Insurance Company Policy Number Payment Options Deposit: $3,000 p.p. Payment Method Pay by Credit CardPay by Direct Debit Credit Card For your security, we do not accept credit card details through this form. Please phone us on (03) 338 1222 or visit our office to make your payment. A 2% surcharge applies to all credit card payments. Direct Debit Travel To You (2005) Ltd Westpac Bank Account Number: 03-1594-0163150-00 Reference: Your surname Please email me a payment receipt. Signature (Type your full name) Date Total Amount (NZD) I have read and agree to the Terms & Conditions.
