Booking Form Tour Information lead participant Please ensure all details are exactly as shown in passport Tour Title: I wish to book places and I enclose a non-refundable deposit of per person being a total amount of £ £ Y M D Departure Date: Y M D Y Y / / Please complete the Reverse of this Form Please see Important Information on inside back cover for all payment terms. Please make all cheques payable to ‘The Cultural Experience’’ Card Number: M M Y Y This is the last 3 digits of the number on the signature strip of your card, except for Amex where it is the 4 digits on the right hand side of the card. Copy this form or call us on 0345 475 1815 if you would like to book multiple tours, add extra nights or upgrade your flights. Additional forms available on our website. (Including intl code) Expiry Date: Security Code: I confirm the name and address of the credit/debit card holder are as for the lead participant above. Name as it appears on the payment card: Signature Print Name: I wish to pay by: Visa Mastercard American Express Debit Card Bank Transfer Cheque Booking Ref: Tour Code: office use only Where did you hear about The Cultural Experience? Please note that the full balance will be required if booking less than 70 days before the departure date of the tour Payment Information Number: Passport Details Nationality: Y M D Y M D Y Y / / Date of Expiry: Y M D Y M D Y Y / / Date of Birth: Further Information (Anything you think we should know, such as special dietary requirements) Address: Single Room Twin Room Double Room Male: Female: Known as: Telephone: Post/Zip Code: Country: Email Mobile: Title: First Name: Surname: Travel/Trip Insurance Details Next of Kin Details Provider: Policy No: 24 hr Contact Tel No: Name Contact No: Relationship: Please see relevant passage in our Important Information for full details on insurance requirements This section is optional. BOOKING AUTHORISATION I have read, understood and agree to accept the booking conditions on behalf of myself and others included on this form. / / Y M D Y M D Y Y Date: Signature Please tick if: • you would like a quote for upgraded travel • you wish to travel‘land only’and exclude our flight arrangements.