Essene Group Reservation Application

Please fully complete the following application in order to register for one of our many wonderful trips.  You may also complete this form and mail or fax (631-361-3682) it to our office. 

 

Reservation Made By

    

TOUR INFORMATION

Destination     Trip to Egypt & Israel with MaSanda Gadd
 Departure Date       November 01-14, 2008

PASSENGER(s) INFORMATION (Names MUST Be Exact Match to Your Passport)
 
Name(s) of passengers (Last / First , Middle) DOB (mm/dd/yy) Nickname

1. 

 

2. 

 
3.   
4.   

Address

    

Address 2

   

City, State, Zip Code

    

Country

   

Home Phone

    

Work/Cell Phone

   

Fax

   

E-Mail(s)

    

EMERGENCY CONTACT
Name   
Phone   

REGISTRATION OPTIONS
Land Only *    I am registering for Land Only * (arrival/departure transfers not included)
Departure City     
Accommodations    
Roommate Request    
Travel Insurance

   I DECLINE Travel Insurance

Travel Insurance will automatically be billed unless you decline coverage at the time of registering. ($225 premium amount based on total trip costs)

SPECIAL REQUESTS
Seat Request   
Meal Request   
Wheelchair Request   
Other Needs   

:::  ADDITIONAL COMMENTS OR INFORMATION  :::

PAYMENT INFORMATION

A $400 per person NON-REFUNDABLE Deposit is due at the time of booking.  Payment in full is required at the time of booking if you are registering with in 60 days of departure. 

A $50 late booking fee is applied for bookings made with in 30 days of departure.

 I wish to make my Instant payment from my Checking Account (Automated Clearing House)

Your Bank Routing Number
Your Account Number 
Amount  

 I wish to make a direct credit card payment (Only * possible if more than 60 days prior to departure)
       Name on Credit Card   

 
       Type of Card               Visa      Master Card      American Express      Discover
  
       Card Number                  Exp. Date

 
        Security Code            

 

 

       Deposit Only * Options (Only * if registering more than 60 days prior to the trip departure date)       

      

 

        Please automatically charge the balance of my trip costs 60 - 70 days prior to departure

 

        Charge total trip costs now (REQUIRED IF BOOKING WITH IN 60 DAYS OF DEPARTURE)

 I wish to pay For My Trip With PayPal (can be done at any time)
       *Paypal payments must be made to account: info@206tours.com

 I wish to make my payment via Check or Money Order. I will send my payment by mail.

       If paying by check mail to:  206 Tours, 333 Marcus Blvd, Hauppauge, NY 11788

 

 

Enrollment in and/or payment for any 206 Tours trip or service constitutes

your unconditional acceptance of all applicable Terms & Conditions.

 

   Initial Here to agree to all Terms & Conditions

 

 

You may also print this form, complete it and fax it to us at (631) 361-3682

 

 

Please review our TERMS & CONDITIONS and TRAVEL INSURANCE. 

If you have any questions please contact 800-206-8687

 

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