FILL AS PRINTED IN PASSPORT
(each line is for one person, if you are single please fill only blue lines)
(Please use BLOCK LETTERS only)
1. Name: Surname:
2.    
 
1. Nationality: Date of Birth (dd/mm/yy):
2.    
 
1. Passport Number: Place of issue:
2.    
 
1. Issue Date (dd/mm/yy): Expire Date (dd/mm/yy):
2.    
 
1. Occupation: Vegetarian: Yes No
2.     Yes No
 
Address of first person to whom all correspondence will be sent
Name & Surname:
Post Code:
Country: Home/Mobile Phone:
Work Phone: E-mail:
 
Emergency contact in case of illness whilst abroad
Name:  
Address:
Post Code: Home/Mobile Phone:
Work Phone : Relationship:
 
How did you hear about us
 
 TOUR INFORMATION
1. Tour Reference: Tour Name(s):
 
1. Departure Date (dd/yy/mm): Number of Days:
 
1. Cost per person: Number of persons:
 
DEPOSIT: (150€ per person)
 Tour Costs: €
TRANSFERRED (total): €
 
Full tour cost: is payable in cash to the company representative when the tour starts.
 
Travel Insurance details:
(Ins. Co., Policy., Emergency.,  Start & end date)
  
Declaration: I have read and accept the booking conditions, on behalf of all persons listed who appreciate the risks inherent in Adventure Travel. I (we) do not suffer from any dissability or pre-existing medical condition which would prohibit full participation in the tour(s)
 
See Booking Conditions Date:
 
SIGNED by person travelling, who must be over 18 years old.

     

Download printable version of this form

Bank Account :

YERDENİZ SEYAHAT ACENTASI TUR. (MIDDLE EARTH TRAVEL)

DENIZBANK Goreme Branch. Nevsehir/Turkiye

YTL ACCOUNT NO : 3640 – 1639120 – 351
SWIFT CODE : DENITRIS
BRANCH CODE : 3640
IBAN NO : TR71 0013 4000 0016 3912 0000 06

EURO ACCOUNT NO :3640-1639120-356
SWIFT CODE : DENITRIS
BRANCH CODE : 3640
IBAN NUMBER : TR760013400000163912000013

DOLAR ACCOUNT NO : 3640-1639120-355
SWIFT CODE : DENITRIS
BRANCH CODE : 3640
IBAN NUMBER : TR060013400000163912000012

Address :

Gaferli Mah. Cevizler Sokak
No: 20, 50180 Goreme
Nevsehir / TURKEY
Phone: +90 (384) 271 25 59/ 25 28
Fax: +90 (384) 271 25 62

www.middleearthtravel.com
e-mail : sales@middleearthtravel.com

  

 

Gaferli Mah. Cevizler Sok. No:20 50180 Goreme - Nevsehir / Turkey   Phone. +90 384 271 25 59   Fax. +90 384 271 25 62
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