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Please specify the destination(s) you would like to visit for your honeymoon or vacation, and the approximate number of nights you would like to stay. Destination:   Number of Nights: 1.   2.   3.   4.   5.   Last Name:   First Name:   Number of passengers travelling:   Type of accommodations:   Single     Double     Twin Please complete the following questions         Preferred departure date:   Total number of days on tour: (incl. travel time)   Places I would like to see: Kenya   Tanzania Amboseli   Ngorongoro Mt. Kenya   Serengeti Lakes Region   Tarangire Samburu   Manyara Masai Mara   Other: Other:           South Africa   Zimbabwe Cape Town   Victoria Falls Sun City   Kariba Kruger Nt'l Park   Hwange Garden Route   Other: Other:           Botswana   Namibia Chobe   Etosha Okavango Delta   Swakopmund Other:   Skeleton Coast     Other: Approximate budget per person:   Do you want to stay in tented accommodations? Yes      No What type of traveller are you?   Budget First Time     First Return     Deluxe   Are there children in your party?   Yes      No If yes, how many?   Children ages (separated by comma)   Children under 7 are not accepted at many lodges in Africa. My Contact Information - * This information is required in order to process this form * E-mail address:   * Address:      Address:   * City:   * State:   * Zip Code:   * Daytime Phone:   Fax:

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