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Applcation Form

• 1.       Country______________

• 2.       Nr. of males___________Nr of Females_______________

• 3.       Nr. of rooms___________(2 beds per room)

• 4.       Name of contact person_______________________

• 5.       Tel nr. of contact person____________________

• 6.       E-Mail address_____________________________

• 7.       Dates from____________  to _________  30 days minimum

• 8.       Date and time of arrival in South Africa________________      
  

• 9.  Airline and flight nr.______________   ___________________

• 10.    Payment currency________________

• 11.   Dietary Requirements if any________________________

• 12.   Any other specific Requirements__________________

• 13. Reference No.______________________(office use only)