Galapagos Islands Ecuador Travel
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EN ESPAÑOLCruceros Galapagos
LAST UPDATED: SEP.20 2011
 

BOOKING/RESERVATION FORM

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PERSONAL DETAILS
EMAIL:
 *Required
SALESPERSON (if assigned):
 *Required


PERSON #1
First name:
Last name:
Gender:
Male: Female:
Passport no.:
Nationality:
Date of birth:
Dietary restriction(s):
Other restriction(s):

PERSON #2
First name:
Last name:
Gender:
Male: Female:
Passport no.:
Nationality:
Date of birth:
Dietary restriction(s):
Other restriction(s):





PERSON #3
First name:
Last name:
Gender:
Male: Female:
Passport no.:
Nationality:
Date of birth:
Dietary restriction(s):
Other restriction(s):

PERSON #4
First name:
Last name:
Gender:
Male: Female:
Passport no.:
Nationality:
Date of birth:
Dietary restriction(s):
Other restriction(s):





No. of People in group:
Adults
Children

To know the road ahead,
ask those who are coming back.
- Chinese proverb
Arrival date in Ecuador:
 Departure date:
Arrival city:
 Departure city:
Flight details:
 Flight details:
Hotel in Ecuador

Emergency contact (telephone):
 Emergency contact (email):





I / We would like to book the following service(s):


  MAINLAND ECUADOR (please indicate the service(s) you would like to book):
DATE(S) SERVICE(S)
 # PEOPLE
 NOTES/COMMENTS
 PRICE

GALAPAGOS CRUISE (please indicate the cruise you would like to book):
VESSEL
 CRUISE START DATE
 DURATION (nights)
 CRUISE END DATE
 CRUISE PRICE
Preferred cabin type:
 We will do our best to accommodate specific cabin and deck requests.
Preferred deck:


GALAPAGOS FLIGHTS (please indicate the flight route you would like to book)*:
ROUTE
 OUTBOUND DATE
 INBOUND DATE
 FLIGHT PRICE (Adult)
 FLIGHT PRICE (Child)
We would prefer to fly to Galapagos on:
 We will do our best to accommodate non-cruise date flight requests.
We would prefer to fly back from Galapagos on:


  PERU (please indicate the service(s) you would like to book):
DESTINATIONS
ANCASH
AREQUIPA
AYACUCHO
CAJAMARCA
CHICLAYO
COLCA CANYON
CUZCO
ICA
IQUITOS
KUELAP
LAKE TITICACA
LIMA
MACHU PICCHU
MANU
NAZCA
PARACAS
PUNO
TRUJILLO
COMMENTS

Please read our booking terms and conditions.
I have read and understood the booking terms and conditions, and hereby submit my reservation details:
       

AFFILIATE SITES

| GALAPAGOS LAST MINUTE | GALAPAGOS & ECUADOR NEWS BLOG | PERU TRAVEL | ECUADOR TRAVEL & PHOTOGRAPHY BLOG |

Amazonas N23-31 (between Veintimilla & Wilson)
Quito, Ecuador - South America.

Tel.: + (593-2) (02) 222-1336 / + (593-2) (02) 256-0428
Tel/Fax.: + (593-2) (02) 256-0426
Skype: sangay.touring

Sangay Touring ®
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