Tourist Australia Tour Booking Form

Please print & complete clearly in block letters and return by mail accompanied by a photocopy of your passport (personal details page/s) and your non-refundable deposit of $300 per person.

Tour Name: 2 Week Conducted Thailand at Leisure Tour Departure Date: 19 May 2010 Name of Passenger 1 (as written in passport)_______________________________ Title:________ Age: ______ Date of Birth:______________ Passport Nationality:___________________________________________________ Passport Number & Expiry Date:_________________________________________ (Must have 6 months validity from the time of tour completion) Frequent Flyer Type & Number (if any):____________________________________ Name of Passenger 2 (as written in passport)_______________________________ Title:________ Age:______ Date of Birth:______________ Passport Nationality:___________________________________________________ Passport Number & Expiry Date:_________________________________________ (Must have 6 months validity from the time of tour completion) Frequent Flyer Type & Number (if any):____________________________________ Address:____________________________________________________________ Telephone / Fax Number:______________ Single / Twin / Double Rooming:__________________________________________ (Room type is subject to availability) Circle which airport you wish to depart from: SYDNEY / MELBOURNE / BRISBANE Special Dietary Needs:_________________________________________________ Flight Seating Request:_________________________________________________ Are you taking our travel insurance?: YES / NO (Please Circle) If NO, please advise of alternative: ________________________________________ Do you have any existing medical conditions?:_______________________________________________________ In case of emergency, please notify: Name:_______________________________________________________________ Address:_____________________________________________________________ Phone Number:______________________ DECLARATION I have read and understand fully the booking conditions and I accept them. Signature:___________________________________________________________ Tourist Australia Online Pty Ltd ABN 38 079 079 011 National Head Office: Rockdale Chambers, Level 1, 534 - 536 Princes Highway, Rockdale NSW 2216 Postal: PO Box 959 Rockdale NSW 2216 Phone: +61 2 9505 8555 Free Call: 1800 170 100 Facsimile: +61 2 9556 1400 Website: http://www.touristaustralia.com.au Email: asiantours@touristaustralia.com.au ***This tour is operated by Macleay Valley Travel and is exclusivley promoted by Tourist Australia***