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Pukekohe Travel Booking Forms (Passenger Details (Title, First name, Last…
Pukekohe Travel Booking Forms
Passenger Details
Title
First name
Last name
Preferred name
Address
Postcode
Phone no.
Mobile no.
Email
Date of Birth
Emergency Contact
Name
Relationship
Contact no.
Email
Passport Details
Passport no.
Nationality
Date of issue
Expiration date
Payment Details
Non Refundable Deposit of $xxxx
Cash
Cheque
Credit Card
Direct Credit
Surname
Reference
BNZ Bank Account 02-0404-0199298-00
Previous Pukekohe Travel Client?
Yes - Apply 10% Discount
No
Confirmation
Date
Signature
Booking Details
Accommodation
Hotel
Double
Twin
Single
Single Share
Cabin
Option 2
Option 3
Option 4
Option 1
Extras
Optional Tours
Flight Extensions
Travel insurance quote required
Yes - Give details
No
Joining Station (Rail Tours)
Return Flights
Cancellation Insurance Quote?
Personal Info
Pre-existing medical conditions?
Yes - Give details
No
Special dietary requirements
Yes - Give details
No
Extra Travel Arrangements?
Yes - Give Details
No
Where did you hear about this trip?
Give Details