French
You are interested by our cruises in the Mergui Archipelago. In order to give you precise information, please fill in the form bellow (no obligation on your behalf).
Your choice:
ECOVOLONTARIAT PROGRAMM
or
EXPLORATION CRUISE
Number of passengers and details
(please fill in all the boxes)
Mr/Mrs
Name
Surname
Date of birth
Nationality
1
2
3
4
5
YOU WANT...
...to leave at the following date
(dd.mm.yy)
...to return at the following date
(dd.mm.yy)
...us to book the fly tickets for you
city of departure
city of return
...us to book the hotel for you
(if yes, fill in the square)
...us to book an annulation-rapatriation assurance for you
(if yes, fill in the square)
YOUR DETAILS
Name
Surname
Address
Zip code
Town / Country
E-mail
Private phone
Prof. phone
Fax
Remarks