One Form For
Each Customer. This Form is Strictly Confidential.
Please print this Booking Form, fill in, sign and return via fax or mail to
the
address provided below. You
must hold a current (valid) passport and obtain
a visa for Ukraine. Ask for our help if needed.
1. PERSONAL DATA
Name:
..............................................................................................................
Address:............................................................................................................
State:.......................................Zip
Code:....................Country:.......
.......
Phone:
Day):.....
........................................Fax:...............................................
Phone (Eve):................................................DOB:
(MM/DD/YYYY)
.
Emails):
.......
Additional data
(optional)
Will
anyone accompany you to Ukraine?
(circle)
Yes No
Do you speak Ukrainian or Russian
(circle)
)
Yes No Some
Have you visited Ukraine before?
(circle)
Yes No
2.TRAVEL
INFORMATION
HOW will
you travel to Kyiv ? (circle) :- 1.Air 2.Train 3.Other
(Ask for our airline tickets service, if needed)
Select accommodation and other information
(circle):
Double Yes No
Single (+US$350) Yes No
Vegetarian Yes No
3. PAYMENT
Total
payment for a double occupancy (land only) is $1,100 per person.
Please enclose a deposit of $250 (non-refundable) by personal check,
payable to
Kolos Corporation, or provide your credit card information:
Credit card:
(VISA, MasterCard)
Card number
..
.
Expires
(MM/YY):
..
Cardholder name
..
Billing address (If different from
the address provided above)
The remaining part of
the total amount should be paid at least 3 weeks before arrival.
Information package with the list
of recommended things to take with you, details
of hotel and trip accommodations, schedules, maps and the recommended
reading
about Trypillian culture will be provided upon your deposit confirmation
receipt.
Your Signature:
............................................... Date:
. |