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Proud Members of:

BOOKING FORM

  • Identify those exciting tours, lodges which appeal to you most.
  • Contact our expert consultants who will discuss your itinerary with you, adding any additional components which you have selected. 
  • Once you have decided on your holiday (or when you are happy with the tailor-made itinerary that we have prepared for you), complete the booking form below and return it to us.
  • We will confirm your holiday as quickly as possible although this might take a week to ten days depending on the complexity of your holiday.

* Denotes required field(s)

Personal details
Title
SurName, as in passport *
First Name(s), as in passport *
Nationality, as in passport *
Date of Birth * (mm/dd/yy)
Place of birth
occupation
Special diet? (eg Vegeterian)
Known medical condition(s)
Are you on any special Medication
Contact Details  
Address 1 *
Address 2
City *
Country *
Telephone (home) Please include country and area code
Fax
Telephone (Mobile)
Email
Passport Details  
Passport Number *
Place of Issue
Date of issue (mm/dd/yy)
Valid Till* (mm/dd/yy)
Tour Details  
Tour Name (refer to itenelaries page for details)
Tour Code (refer to itenelaries page for details)
Proposed departure date (mm/dd/yy)
Tour Duration
If you have any special interest please specify
( eg Gorillas, wildlife, etc. separate with comas)
Type of accomodation 
Room type required


Additional interests, notes and or Specail instructions
How did you hear about us Friend
Advertisement (state publiaction  )
Travel Agent  (State Agent Name
Other please specify                   


 

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 Skype: alex.mango
Exclusive African Safaris Ltd

Mobile: + 256 (0) 772 887 484|
Tel/Fax: + 256 (0) 414 286 415|
email: info@exclusiveafricansafaris.com |
Website: http://www.exclusiveafricansafaris.com |