First Name
Last Name
Title
No. of Adults
Children
Hotel To Stay
Street Address
Address (cont.)
City
Country
Cell Phone
FAX
E-mail
Arrival Date
Departure Date
Arrival Time
You are Booking	8 Days Aberdares,  Samburu, Sweetwaters, Lake Nakuru and Maasai mara

             Arrival Airport      Please Select One Jomo Kenyatta Aiport- Nairobi Moil Airport- Mombasa   Transfer Required Please Select one YES NO                                  

            Please select the safari lodge/camp and mode of transport of your choice from the drop-            down lists below.

            Lodges/Camps  Please select one The Ark, Samburu Lodge, Sweetwaters camp, Lake Nakuru Lodge and Mara Simba Lodge Aberdare Coutry Club, Samburu Serena, Sweetwaters camp, Sarova Lion hill and Mara Serena Safari Lodge

 Other Lodges; Please specify          

            Jeep/Minibus? Please Select One Jeep Safari Minibus

   Please Enter the Date of your Safari  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 Day January February March April May June July August September October November December Month 2009 2010 2011 Year

             Additional Requests (Please Provide Full Names of the Party)