Name:

Address:

Address 2:

Town:

Postcode / Zip:

Telephone No:

Best time to contact you:

Email Address:

Areas of specific interest:

Have you been on Safari before?

Yes No

Where did you go?

At which places did you stay?

Please give us any further information regarding your hobbies and interests so that we can know a little more about you. ie: walking / fishing / photographing / camel or horse riding / bird watching / canoeing / scuba diving / botany / winelands (for South Africa) / mountain climbing / architecture / history / textiles (in the case of India).

Do you have any particular species that you would like to see, ie: wild dog / southern right whale / chimpanzees / gorillas / desert dwelling elephant and rhino / shoebill stork / white backed night heron / Angolan Pitta / Pels Fishing Owl, or in the case of India any special areas, monuments or wildlife species that particularly interest you?

Please let us know if this is celebrating a special occasion, such as a honeymoon, wedding anniversary (and which one), or a family holiday.

Further Information:

Please indicate your areas of interest:

India
Africa
Indian Ocean Islands
The Galapagos Islands

Approximate budget excluding airfare per person:

---- £1000 - £2000 £2000 - £4000 £4000 - £6000 £6000 - £8000 £8000 - £10000 £1000 - £10000+

Would you like to receive our email newsletter

Yes No