Booking Form - Asia
KUMUKA BOOKING REFERENCE:
Please return this completed form to your agent or to:
Kumuka Worldwide, Level 5, 387 George Street, Sydney NSW 2000
Tel: 02 9279 0491 Fax: 02 9279 0492 E-mail: sales@kumuka.com.au
Passenger Details - PLEASE COMPLETE IN BLOCK CAPITALS AS PRINTED IN PASSPORT
MR/MRS DATE OF BIRTH DATE OF ISSUE EXPIRY DATE
MISS/MS FIRST NAME SURNAME NATIONALITY PASSPORT NUMBER DD/MM/YY PLACE OF ISSUE DD/MM/YY DD/MM/YY OCCUPATION
1) / / / / / /
2)
/ / / / / /
3) / / / / / /
4) / / / / / /
Address Details for all correspondence - Please notify us immediately if your address should change
HOME TEL: In an Emergency contact the following:
WORK TEL: Name:
TOWN/CITY MOBILE: Relationship:
POSTCODE
E-MAIL: Tel:
Tour details - List below the tour(s) which you wish to book
DEPARTURE DATE
TOUR REF TOUR NAME(S) DD/MM/YY JOINING POINT FINISHING POINT MEDICAL AND DIETARY TOUR COST
/ /
$
/ /
$
Travel Insurance - compulsory for all passengers
WE REQUIRE KUMUKA’S APPROVED INSURANCE
ALTERNATIVE COVER HAS BEEN ARRANGED
Pre & Post Tour Accommodation - Extra Hotel night(s)
If you plan to arrive early or would like to spend extra time at the end of your holiday and wish us to book additional nights accommodation for you, please complete this section.Wherever possible, accommoda-
tion will be booked at the hotel which is designated as the meeting point for your tour. If you are travelling alone, extra nights accommodation must be booked on a single room basis.
NUMBER SINGLE DOUBLE TWIN
CITY DATE IN DATE OUT OF NIGHTS
PRE-TOUR / / / / ROOM TYPE-
POST-TOUR / / / / ROOM TYPE-
Payment details - Cheques should be made payable to Kumuka worldwide
Please charge my Credit Card account with the following amount - DEPOSIT - AU$300 PER PERSON
$
Full Payment/Deposit
$
- NZ$400 PER PERSON
OR FULL PAYMENT
$
NAME ON THE CARD
(if within 60 days of departure)
TOUR FUND (if applicable)
(TICK AS APPLICABLE)
$
MASTERCARD DELTA SOLO MAESTRO VISA AMERICAN EXPRESS
INSURANCE
CARD NUMBER
$
(Compulsory for all passengers)
EXTRA HOTEL NIGHTS
$
MAESTRO CARD ONLY VALID FROM EXPIRY DATE
ISSUE NUMBER
TOTAL COST
$
Travel Agent Stamp
Card Holder’s SIGNATURE:
I have read the booking conditions and accept them on behalf
of all members of my party by whom I am duly authorised to
make this agreement. I also agree to pay any balance no later
DATE: than 60 days before departure
.
HOW DID YOU HEAR ABOUT KUMUKA?
SIGNATURE
Date:
Bangkok Hotel
Contact Us UIforward 81
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84