Registration form Israel

STARGATE INTERNATIONAL GROUP TOUR OPERATORS

P.O. Box 1151

O.R. Tambo International Airport 1627

Tel: 011-9187567 / 9187612

Fax: 011-9187632

REGISTRATION FORM

Identification info

Personal info

Title *

Surname *

Maiden name *

First name(s) *

Identity number *

Name *

Occupation *

Passport info

If passport is available please complete the passport info section.

Passport type

Other nationality *

Passport number

Date issued

Place issued

Date of expiry

Place of birth(Town/ City)

Contact details

Residential address

Postal address

Contact numbers

Telephone

Telephone(H)

Telephone(W)

Cell number

Next of kin

Next of kin *

Contact number *

Fax en e-mail

Fax number

e-mail address *

Confirm e-mail address *

Tour info

Tour leader and Departure date *

Have you selected a tour leader? *

Tour description

Special requests

Room options

Single room supplement fee

If we cannot provide you with a shared room as requested, the single room supplement fee will be for the account of the passenger. See the itinerary for the fee under "Not included"

Room options Double room
Twin room
Triple room
Single room

To share a room

Banking details

I agree to pay a deposit of R3 000 per person(not refundable) as a registration fee for the abovementioned tour within 48h00, after completion and sending of this e-mail. In the case of a direct deposit into our account, please fax the deposit slip and the registration form to our offices at(011) 918 7567. You will receive a copy of the registration form directly after completion of the online registration. Registration is valid only if the deposit has been received by Stargate as mentioned above.

Bank details: STARGATE INTERNATIONAL, ABSA Bank, Estlands -Cheque account.

Branchcode: 632005 Accountnumber: 1022810355

Reference on Deposit slip:

Your surname(example: Steyn) followed by the departure date(24 Okt) followed by the first letter of the tourleader's name(example: Isak) and surname(example: Burger).

(example: Steyn 24Okt IB)

Agreement

I herewith accept the"Notice to participants" and agree that my participation is subject to the rules and regulations as read in the "Notice to participants"

Notice to participants read * Agreement accepted * Date

Security

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Groeptoer Operateurs ~ Group Tour Operators