GAP STUDENT BOOKING FORM FOR 2012 EVENTS

including Topdeck & Contiki Tours

(please photocopy if needed by friends)

NAME (as it appears in passport)

...........................................................................................................

(First names)                                         (Surname)

ADDRESS    Postal: …………………...................................................

City.............................................State...................Post Code............

E-MAIL           Personal:....…………….................................................

Parents:  ………………....................................................

PHONE NUMBERS:           Mobile: …………………………………………

Home: ....................................................Fax: ....................................

PASSPORT     Nationality…................................. No. : ...........
 D.O.B …./…./….....

 Date of issue ..................................... Date of expiry .........................................

MEDICAL & DIETARY       Any special requirements?  ………………………............................................................................

TOUR DEPARTURE DATE   Tour Co……...………………................... Date ……………….......................

TRAVEL INSURANCE      Do you wish to take out our discounted GAP travel insurance?  If not, please provide details of alternative cover.

⃞YES    ⃞ NO       Company: ……………..........................  Policy No.: ………………..

HOTEL ACCOMMODATION       

Do you wish us to book accommodation for you at the budget hotel from which the Tour departs early in the morning?                   

For the night before departure               YES/NO

                    For the night after your return               YES/NO