Inca Mysteries
Reservation Form
August 7 -15, 2014
Name(s):
1.________________________________________________________________________________________________________
First
Middle
Last
Passport #: __________________________________ Date of Issue: ________________ Date of Expiry: __________________
Date of Birth: ______________________
c I would prefer a single c I would like to request a share
2.________________________________________________________________________________________________________
First
Middle
Last
Passport #: __________________________________ Date of Issue: ________________ Date of Expiry: _________________
Date of Birth: ______________________ c I would prefer a single c I would like to request a share
Address:__________________________________________________________________________________________________
City: _____________________________________________________________ State: ______________ Zip: _______________
Telephone: Day _________________________ Night _________________________ E-mail:_____________________________
Preferred Departure City:_____________________________________
c Lake Titicaca Extension
I accept/decline Travel Insurance (refer to Terms & Conditions): c Accept
c Decline
Tour Deposit Amount ($500/person), plus insurance if accepted: $____________________
c Check Enclosed
c Credit Card
Form of Payment:
Card #: ______________________________________ Security Code: __________ Exp. Date: _____________
Billing Address: ____________________________________________________________________________________________
City: _____________________________________________________________ State: ________________ Zip: ______________
I have read the Terms & Conditions which apply and agree to abide by the same.
Signature: __________________________________________________________________ Date: ________________________
For reservations & information, contact:
SITA World Tours | Mary Barnett
Tel 800.421.5643 x 1518 • Fax 866.234.8786
E-mail [email protected] • Web www.sitatours.com
16250 Ventura Blvd. Suite 300, Encino, CA 91436
CST# 2003643-40