RESERVATION FORM FOR YAMATO’S TOUR OF IRELAND WITH PHILIPPE THERIAULT JULY 5-15, 2016 (U.S. citizens require a valid U.S. passport) Dr. Mr. Mrs. Ms. __________________________________________ Birthdate ___________ (Print complete name as shown on your passport) Passport No. ______________ Expires __________ Occupation __________________
Dr. Mr. Mrs. Ms. __________________________________________ Birthdate ___________ (Print complete name as shown on your passport) Passport No. ______________ Expires __________ Occupation __________________
Home Address_________________________ City________________ State ____ Zip______ (If final documents are sent by UPS, they cannot deliver to a P.O. box.) Phone: Home ________________ Business _____________ Cell ___________________ Email address: ________________________________________ Fax: _________________ Airline Mileage No. : ___________________________________________________________ (Specify no. for each person.) Note: If you arrange your own air, please let us know as soon as possible. Send us your flight itinerary once it is confirmed. Hotel room preference: Smoking _______ Non-smoking _______ Other special requests: _____________________________________________________ Do you have any special dietary, medical or physical needs of which we should be aware? ____________________________________________________________________________ Please provide name, relationship, and phone number of person to contact in case of emergency: ____________________________________________________________________________ Please send: completed reservation form, deposit of $500 per person, and copy of your valid passport, to: YAMATO TRAVEL BUREAU® 250 East First Street, Suite 1112, Los Angeles, CA 90012-3827 Please note: After confirmation, final payment is due by May 31, 2016 Phone: (213) 680-0333 or (800) 334-4YTB (outside of local area) Email: groups@yamatotravel.com CST # 1019309-10 |
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