Tour Reservations
Items with * are required
Tour Name*
Trip Dates
Deposit Enclosed
Applicant Name (First, Last)*
Age
Street Address
City
State
Zip
Email*
Home Phone
Work phone*
Birthplace
Citizenship
Passport Number
Date of Expiration
GENERAL HEALTH INFORMATION (Specific information maybe requested of you depending on the trip)
State of Health
Good
Fair
Poor
Dietary Preferences/Restrictions
Vegetarian
Vegan
Diabetic
Other (Please specify)
Other
In case of emergency, please notify:
Name
Phone
Address
City
State
Zip
Relationship
Medical Insurance
Name of Medical Plan:
You may either click on submit to send this form, or print it and mail it in to us at:
3806 Whitman Avenue North
Seattle, WA 98103 - 8724
United States of America
Signature:
Date
Copyright 1999-2004 Caravan-Serai Tours Inc. All Rights Reserved.
