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Please complete this form, print it and return it with your deposit of AUD$ 400 to Italia Mia, a division of Travel Avenue, 101 Bridport St, Albert Park VIC 3206, Australia A booking confirmation will be promptly sent to you for your records Please Note: the fields marked with a red asterisk need to be filled to process your request. All other fields are optional. Upon receipt of full payment for your Vita Italian Tour, a pre-departure pack will be sent to you containing your confirmed itinerary, accommodation details and information on your selected tour
Mr Mrs Ms Miss First name* (as shown on passport) Surname* (as shown on passport) Date of birth* (as shown on passport) Mailing Address* City* State* Postcode* Country* Telephone home* (including area code) Telephone business Fax Email Requested Tour* Tour 1 Tour 2 Tour 3 Tour 4 Tour 5 Number of people travelling* Requested accommodation* Double room Single room Twin room If more than one adult, please list names of other persons travelling with you* NOTE: if different contact details, please fill out one form each
DECLARATION* I have read and agree to accept the Terms & Conditions of Vita Italian Tours as set out in the Terms & Conditions page of this web site. I also agree to arrange adequate Travel Insurance. Date* Signed*