Please indicate age (required for travel insurance purpose only) |
Please indicate approx. weight (required for air charter purposes only) |
||
FULL NAME: |
0) && in_array('Full name is required',$form_errors)){ print ' style="border: 1px solid #CC0000;" ';}?> value="(isset($_POST['FULL_NAME']))? (print $_POST['FULL_NAME']):(print "");?>" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF';this.style.border='1px solid #999933'" /> | ||
YOUR COMPANION’S NAME: |
" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF'" /> | ||
E-MAIL ADDRESS: |
0)) { if(in_array('A valid email address is required',$form_errors) || in_array('Your email address is not correctly formatted',$form_errors)){ print ' style="border: 1px solid #CC0000;" '; }}?> value="(isset($_POST['E_MAIL']))? (print $_POST['E_MAIL']):(print "");?>" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF';this.style.border='1px solid #999933'" size="30" /> | ||
ALTERNATIVE E-MAIL: |
" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF'" size="30" /> | * Requested incase primary e-mail bounces back | |
TELEPHONE: |
0) && in_array('A phone number is required',$form_errors)){ print ' style="border: 1px solid #CC0000;" ';}?> value="(isset($_POST['TELEPHONE']))? (print $_POST['TELEPHONE']):(print "");?>" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF';this.style.border='1px solid #999933'" size="30" /> | * Day time telephone requested, incase of a question | |
STREET ADDRESS: |
0) && in_array('Your complete address is required',$form_errors)){ print ' style="border: 1px solid #CC0000;" ';}?> value="(isset($_POST['STREET']))? (print $_POST['STREET']):(print "");?>" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF';this.style.border='1px solid #999933'" size="30" /> | ||
CITY: |
0) && in_array('Your city is required',$form_errors)){ print ' style="border: 1px solid #CC0000;" ';}?> value="(isset($_POST['CITY']))? (print $_POST['CITY']):(print "");?>" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF';this.style.border='1px solid #999933'" size="30" /> | ||
STATE: |
|||
ZIP: |
value="(isset($_POST['ZIP']))? (print $_POST['ZIP']):(print "");?>" onfocus="this.style.background='#EEF9C8'" onblur="this.style.background='#FFFFFF';this.style.border='1px solid #999933'" size="10" /> | ||
COUNTRY: |
|||
SELECT YOUR DATES OF TRAVEL: | " id="departure" class="travelplanner" onfocus="this.select()" /> | " id="return" class="travelplanner" onfocus="this.select()" /> |
OR; IF YOUR SCHEDULE IS SOMEWHAT FLEXIBLE, SELECT: |
" id="earliest" class="travelplanner" onfocus="this.select()" /> | " id="latest" class="travelplanner" onfocus="this.select()" /> |
PREFERRED CITY OF DEPARTURE: | " type="text" style="width:190px; margin-right:10px;" /> | * If different from home city specified above. |
DO YOU WISH TO PURCHASE INTERNATIONAL AIR TICKETS FROM US?
/>
YES
/>
NO |
IF USING FREQUENT FLIER MILES TO PURCHASE AWARD TICKETS OR UPGRADES,
PLEASE SELECT YOUR MEMBERSHIP CARRIER: |
WHICH CAMPS / REGIONS WOULD YOU LIKE TO HAVE FEATURED IN YOUR CUSTOM SAFARI?
Please select all that apply. Camps that are pre-checked indicate that you had previously added them to your enquiry.
Click on Camp name to open a new window displaying additional information on it.
BOTSWANA | |
/> | MOMBO CAMP |
/> | VUMBURA PLAINS |
/> | KINGS POOL |
/> | JAO CAMP |
/> | JACK’S CAMP | /> | ABU CAMP |
/> | KWETSANI CAMP |
SOUTH AFRICA | |
/> | SINGITA BOULDERS LODGE |
/> | SINGITA EBONY LODGE |
/> | SINGITA SWENI LODGE |
/> | SINGITA LEBOMBO LODGE |
/> | LONDOLOZI TREE CAMP |
/> | LONDOLOZI PIONEER CAMP |
/> | THE ELLERMAN HOUSE |
ZAMBIA | |
/> | THE RIVER CLUB (Victoria Falls) |
/> | TONGABEZI LODGE |
NAMIBIA | |
/> | SOSSUSVLEI WILDERNESS CAMP |
/> | LITTLE KULALA CAMP |
/> | LITTLE ONGAVA CAMP |
/> | SERRA CAFEMA CAMP |
SEYCHELLES | |
/> | NORTH ISLAND SEYCHELLES |
/> | FREGATE ISLAND SEYCHELLES |
/> | BANYAN TREE SEYCHELLES |
/> | BIRDING | /> | PHOTOGRAPHY | /> | BIG GAME VIEWING | /> | SPA | /> | FISHING |
/> | FIRST AFRICAN SAFARI | /> | HONEYMOON | /> | ANNIVERSARY | /> | BIRTHDAY |