First Name:
Last Name:
Address:
City:
State: Zip Code:
Country:
Office Phone: Fax at Office:
Home Phone: Fax at Home:
e-mail address:
(we will send your sketchy itinerary to the e-mail address you type above)
# of Participants:
# of Adults:
Children under 12:
Arrival Date: in Costa Rica
Departure Date: from Costa Rica
# of Nights:
Single (1 pax)
Double (2 pax)
Triple (3 pax)
Quad (4 pax)
Multiple items may be chosen.
Type of Room Comments:
Naturalism
Recreation
Birdwatching
Fishing
Business
Looking to Retire
Other (please specify)
Multiple items may be chosen.
Main interest Comments:
| Places you would like to visit | Hotel preferred | # of nights |
|---|
Additional Comment on Places:
MS Word 6.0+
Word Perfect 5.0+
Text (ASCII)
Windows
Macintosh
Multiple items may be chosen.
Document Format Comments: