| CONTACT INFORMATION |
| Title: |
*
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| First Name: |
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| Last Name: |
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| Country: |
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| Email: |
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| Phone: |
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Contact me via:
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Email
Phone
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| TRAVEL ITINERARY INFORMATION |
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| * Which of the following
destinations are you interested in travelling? |
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* For which destination
would you like to request further information?
(if you are considering several destination for your travel plans,
please inquire in the destination you believe is the lead destination) |
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| I know the exact dates of my holidays and I want to
travel: |
| From: |
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| To: |
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I am unsure but probably in
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* I would like to travel for:
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I prefer you to organize my trip with a majority of:
Standard hotels
First-class hotels
Superior hotels 
Deluxe hotels 
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*I would like you to organize my trip on a:
Room and breakfast basis
Half board basis
Full board basis
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I am interested in:
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Do you already have your international flight tickets?
Yes
No
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Do you require any airline assistance for your
international flights?
Yes
No
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* How many adults will be
travelling?
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How many infant(s) below two years will be travelling?
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How many child/children will be travelling?
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The group is:
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If other, please specify:
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Any other information you would like to include? Please
be as precise as possible
(special requirements in terms of diet, journey, length, must-see
places, etc…) |
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* How did you hear about
us?
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If other, please specify:
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Please enter the confirmation code: * 
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Thank you very much for taking the time to fill in our Independent
Travel Planner which will help us provide you with a very
detailed and personal answer within 48 business hours .
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