RESERVATION REQUEST FORM

Fill out and print this form and mail it to:

TunisUSA
175 Strafford Avenue, Suite ONE # 500
Wayne, PA 19087-3396

Tour Name:
Tour Departs:
Cost per person is $
Total cost is $
Enclosed is my deposit of $350 for each of	person(s).
The balance of payment is due in full six weeks prior to departure.
Your Name:

Street Address:

City:  State: Zip:  

Telephone (day):

Telephone (evening):

By submitting this application I agree to the general terms posted at TunisUSA and any specific terms relating to the package I am requesting.

Signature This document must be signed

On a separate sheet of paper please provide the

• passport number
• country of issue
• expiration date
• birth date

for each member of your party.

Also, please note any special sleeping arrangements you may require.