2014/15 - Botanica 2nd edition

botanica world discoveries Booking Form It is a condition of travel that this form is completed, signed and returned to one of these offices prior to departure. Please complete the form below and send to: AUSTRALIA Level 4, 1230 Nepean Highway, Cheltenham VIC 3192 Cruise / Tour Name: UNITED KINGDOM 7 Whiledon Street, Old Amersham, Buckinghamshire HP7 0HT Departure Date: Cruise / Tour Code: Have you already made this booking? NEW ZEALAND Suite 4, Level 1, 20 Augustus Tce, Parnell, Auckland 1151 Yes/No Cancellation Cover: Would you like Botanica Deposit Cancellation Cover (see page 5)? No Yes Booking Number: Flights: Would you like us to organise your flights? Passenger One (name as shown on passport) Title Surname Given Name Preferred Airline: Yes No Preferred Class: Preferred Name on Badge Passenger Information Do you have any special dietary requirements? Address: City:Postcode: Telephone Number: (H) Will you be celebrating a special occasion while on tour? (M) Email Address: Date of Birth: Are you a: Relationship to passenger: Preferred Name on Badge Address: (M) Card No: Email Address: Date of Birth: Visa Mastercard Amex/Diners Club Cheque attached Expiry: / /20 Charge Amount of: $ Nationality: Name on Card: Expiry: We declare that the information we have given is true and correct, and we have read and understood and accepted the terms and conditions on pages 53 & 54. In the event of a change we will notify Botanica to advise anything that may effect our reservation: Passport Number: Date of Issue: Telephone: Payment Please enclose your deposit of $1,000 per person per tour, or $2,000 per person per cruise ($200 per person for Australian and New Zealand tours). Please note credit cards will incur a credit card surcharge. Type of Card: City:Postcode: Telephone Number: (H) Garden Club Member Name: Expiry: Passenger Two (name as shown on passport) Title Surname Given Name Diggers Club Member Emergency Contact Information In the event of an emergency, please supply a contact name and telephone number to be used: Nationality: Passport Number: Date of Issue: Botanica Club Member Suite Preference: If you are booking a cruise, please select your preferred suite category from the information provided on the relevant itinerary. See pages 49-52 for deck plans. Passenger One Signature: Date: Accommodation Required: Single Room Twin Beds Double Bed Passport: Please tick to confirm you have included a photocopy of your passport: Travel Insurance: If you require assistance with travel insurance, Botanica recommends AIG Insurance. For a quote and to purchase your travel insurance, please go to www.aigtravel.com.au/apt or call their friendly staff on 1800 017 682 – please make sure you identify yourself as an APT Group customer. Passenger Two Signature: Date: A reservations consultant will contact you once this form is received. The booking will be confirmed upon receipt of the deposit. All deposits are required within seven days of booking confirmation otherwise booking will be cancelled. Please refer to pages 53 & 54 full terms and conditions. ABN 44 004 684 619 Lic. No. 30112 55

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