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South American Panorama

For SINGLE TRAVELLERS 40 to 59 years
17 August - 05 September 2010 (20 days)

REQUEST QUOTE

To request a quote, complete the online form below.
We will reply with a quote and information on how to confirm a booking if you wish to proceed.
Note: you are not committed to the holiday until you pay the deposit.


Early Bird Saving Book with a deposit paid by 17 Febuary 2010 & SAVE $150 off standard tour price
Deposit: $400 deposit per person
Bookings Close: 18 June 2010 (or before if places sell out)
Final Payment Date: 18 June 2010
Other Payment: Room mate match service fee @ $35

Booking on your own? We get the majority of our bookings from people making bookings on their own. We provide a room mate matching service (same gender) to share a twin room and take advantage of the twin-share room rates!


Make a Selection
Enquiry only - please send more information (provide details of the nature of your enquiry in the additional comments field at end of form)
I am considering booking, please send me a quote.
I would like to book; please send me a quote (there is no commitment until you pay a deposit)

Your room type
I'd like to book a single room (just for me).
I'd like to book a twin share room (for me and my friend).
I'd like to book a twin share room (with a room mate match).

Which holiday package?
Tour only
Tour & Airfare quote

Have you booked a holiday with us before? Yes     No

Your closest departure city  

YOUR DETAILS

Please include your name exactly as it appears on your PASSPORT

Title:
First Name:  
Middle Name: (only if travelling overseas)
Surname:
Preferred First Name: e.g you're 'James' but prefer 'Jim'
Gender: Female     Male
Date of Birth:
Email Address:
Confirm Email Address:
Street Address:
Suburb:
State:
Country:
Postcode:
Home Telephone:
Mobile:
Work Telephone:
City of Birth:
Country of Birth:
Passport Number:
Nationality:
Passport Place of Issue:
Passport Issue Date:
Passport Expiry Date:
If you do not have a current passport this information can be provided at a later date.

Do You Smoke? Yes     No

Special Dietary Requirements (tick any that apply)

  No special diet needs I am a vegetarian (no meat/no seafood) I do not eat red meat
  I do not eat shell-fish (crustaceans) I do not eat seafood I do not eat chicken
  I do not eat pork I am a vegan Dairy-free diet
  I do not eat eggs Gluten-free diet I have a nut or peanut allergy
  Wheat-free diet Low fat diet Low salt diet
  Low calorie Others (please specify)

Fit to Travel

Do you suffer from any disabilities? Yes     No
Can you ascend stairs without assistance? Yes     No
Do you require a Disabled Room? Yes     No
Please provide details of any disabilities or write NO if none:
Please advise any other medical conditions (including medical aids) or write NO if none:

Flight Preference
My seat preference on flights is:  

Frequent Flyer Details
Frequent Flyer Airline:      Frequent Flyer Number: 

In Case of Emergency, whom shall we contact?
In case of an emergency, please provide details of a person we can contact (family or close friend)
Name:  
Relation:  
Phone: No:  
Mobile:  

YOUR FRIEND'S NAME
If sharing with a friend, each person must submit a booking form in order to each agree to the booking terms and conditions. Please complete the following section if you are sharing a room with a friend.

First Name:
Surname:
Gender: Female     Male
YOUR FRIEND must complete their own booking form and
also nominate you as the person who is sharing the twin room with them.


Courier Delivery Details - only applies to addresses in Australia
When we send out your travel packs, in some instances we use a courier. Please provide an address for delivery Monday to Friday during business hours that can sign to accept parcels.

(tick if applies) use the same address as postal address provided. Note: Couriers can not deliver to PO Boxes.
Building or Level:
Business Name:
Street Address:
Suburb:
State:
Postcode:
Name of Person:
 This is the name of the person who will sign for the parcel.
Tick which applies This is a business address This is a residential addess

Where did you hear about us?     

Additional Comments
Please provide details of any additional requests below:

Verification Code: Write value of the image Change Image

Write the characters in the image above
I acknowledge that by ticking this box that I have read and accept the terms and conditions for
South American Panorama
YES, please send me an email with Holiday Alerts when new holidays are announced that match my age.

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