Access America Travel Insurance Protection Products

RESERVATION REQUEST FORM

Fill out and print this form. Hand-mail it to TunisUSA.

Tour Name:

Tour Departs:

Cost per person is $

Total cost is $

Enclosed is my deposit of $350 each for of person(s).

The balance of payment is dues 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.