Direct Request

This form is not a brochure request but a quote demand for a Taylor Made program. Once you'll send us this form fully completed, one of our consultants will get in contact with you to propose you a detailed program and budget that will entirely fullfill your desires.
We thank you for filling in this form.

Personal Details

E-mail	:			Number of adults	:
Confirm E-mail	:			Number of children	:
Name	:			Country of Origin	:
First Name	:			City/Airport of departure	:
Telephone	:	Country Code   +      Number :
Age of participants	:

Dates of vacation

Arrival	:	Day 12345678910111213141516171819202122232425262728293031 MonthJanuaryFebruary MarchAprilMayJune JulyAugustSeptember OctoberNovemberDecember Year2008200920102011201220132014201520162017201820192020
Departure	:	Day12345678910111213141516171819202122232425262728293031 Month January February March April May June July August September October November December Year2008200920102011201220132014201520162017201820192020

Technical Details

What type of vacation are you planing?			Which country(ies) is(are) interresting you? (max 3)
	Honeymoon or wedding anniversary			South Africa
	Group of friends (thematic program)			Botswana
	Family trip (privacy and friendlyness)			Mozambique
	Discovery and adventure (at a sustained pace)			Namibia
	Exclusivity, emotions, relaxation (Service++)			Zambia
				Zimbabwe
What is your budget? (including international flights)			What is the most important for your stay? (5 means the most important)
				1	2	3	4	5
	5000 - 6000 €/pers		Confort & Luxury
	6000 - 7000 €/pers		Landscapes
	7000 - 8000 €/pers		Animals
	€/pers		History & Culture
			Gastronomy & Wines
			Adventure & Sport

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