Tour Enquiry Form

Traveler Information - Details

Traveler Contact Name*
Street
City
State / Province
Postal Code
Country*	Select Country United States United Kingdom Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo Congo Democratic Republic Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-bissau Guyana Haiti Vatican City Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea South Korea North Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libyan Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Email*
Day time contact #
Mobile Phone
How many people wish to travel?	1 2 3 4 5 6 7 8 9 10 11 12
Number of days on trip?	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Number of single rooms	0 1 2 3
Number of double/twin rooms	0 1 2 3
On what date would you like to begin your tour?	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec 2007 2008
Which Tour - indicate the featured tour you want to register for or if your are requesting details for a custom-made itinerary please outline your proposal in the text box further down this form. Select option from drop down menu UT1 - Great Apes and Wildlife 9 Days UT2 - Gorillas and Wildlife 6 Days UT3 - Wildlife, Chimpanzees and Birds 5 Days UT4 - Gorilla Trekking 4 Days UT5 - Murchison Falls 4 Days UT6 - Uganda and Rwanda 10 Days: UT5 - Murchison Falls 4 Days RT1 - Gorilla Trekking 4 Days RT2 - Gorilla Trekking 6 Days RT3 - Primates and Birds 6 Days RT4 - Akagera 3 Days CUSTOM MADE ITINERARY

Please indicate below privious travel experiences in Africa

Please specify any special requests or alternative tours of interest to you or outline your 'Custom-made' tour below?

*Denotes Required Field

---

Traveler Information - Please Specify Your Interests

Game Viewing
Ornithology
Gorilla Tracking
Chimpanzee and Primate Tracking
Hiking
Mountain Climbing
White Water Rafting
Other (Please Specify)

What areas are you interested in? Please note that not all may be available at any one time or in combination together.

Murchison Falls National Park
Queen Elizabeth National Park
Bwindi Impenetrable National Park
Mgahinga National Park
Kibale Forest National Park
Semilki Valley Game Reserve
Kidepo Valley National Park
Lake Mburo National Park
Parc Nationale des Volcanes(Rwanda)
Akagera (Rwanda)
Other (Please Specify)

---

Your email address is a required field for the successful completion of this form as you will receive a confirmation of the submission