Trip Reservation Form

Note this is only a request for travel. Your trip will not be reserved or your credit card charged until one of our agents replies to your query and finalizes details of your request.
If you do not hear from us in a timely manner please call (905) 439-5530.

Trip being requested:
Departure Date:
Accomodation:
Price:
Passport Name 1:
Passport Name 2:
Usual First Name 1:
Usual First Name 2:
Birthdate Person 1:
Birthdate Person 2:
Address 1:
Address 2:
City:
Prov/State:
Other Prov/State:
Postal/Zip:
Country:
Telephone:
Fax:
Email:
	Please quote my/our air reservations from:
Location:
	Please contact me regarding cancellation and health insurance:
Insurance Quote:
	Please use this space if you have any questions about your trip, or to advise us of any health or physical limitations that you may have, or wish to request additional travel arrangements:

	I hereby authorize Travelonly to charge the following to my credit card, as follows:
Card Type:
Card Num.:
Expiry:
Name on Card:
Amount:
Signature:

Travelonly – Jim Marsh

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Trip Reservation Form