Name of Adult ( Title, Firstname, Lastname )

1

Mr. Ms *

2

Mr. Ms

Children: ( 2 - 11 years old ) ( Title, Firstname, Lastname, Date of Birth)
NOTE: Mstr - male child and Mist - female child 2-11 years old.

1

Mstr. Mist / - 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 - January February March April May June July August September October November December - 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

2

Mstr. Mist / - 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 - January February March April May June July August September October November December - 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Infants: ( below 2 years old ) ( Firstname, Lastname, Date of Birth )

1

/ - 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 - January February March April May June July August September October November December - 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Note: Please furnish complete e-mail address so that our reply could reach you.

E-mail Address

*

Alternative E-mail Address

 Optional

Home Phone Number

*

Business Phone Number

 Optional

Mobile Phone Number

 Optional

Fax Number

 Optional

Country of Residing

Nationality

*

Company Name ( if applicable )

Correspondence Address

*

Flight Details

Departure Airport

*

Arrival Airport

*

Preferred Airline

*

Class Of Journey

*
(First / Business / Economy)

Type of Trip

One Way Round Trip *

Departure Date

*

Return Date Applicable only for Round Trip

Payment Details ( Note: A credit card payment form shall be sent to you thru e-mail in reply to the above reservation.)

By Credit Card

- Amex MasterCard Visa   

By Bank Transfer ( US Dollars Only )

Delivery Option ( Note: Please indicate how you would like to have the ticket(s) delivered. Kindly chose one from the four options. )

Courier Service

Send by Fedex. Please furnish your address and add another fee for courier charge.

Deliver to Hotel

If you are staying overnight in Dumaguete

Send PTA Ticket

Please furnish us your complete address, Tel # & fax #

Do you need Hotel or Resort Accommodation?

Nights

Hotel/Resort

Budget per person

Select Here $US 60 - 80 $US 80 - 100 $US 100 - above

Transportation

None Airport - Hotel Hotel - Airport Airport - Hotel - Airport

Required arrangements

Select Here Room Only Rooms with Breakfast

Date of

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