Booking By Fax Form For one guest (Credit Card version)
For couples or guests sharing same room /Cabin: Please click here
Please print out this form using your computer's printer, fill in the information, sign and mail ( if you are booking at least 60 days in advance) or fax it to Nubian Nile Cruises, Inc. in the USA at : Fax : 415 -358-6845
First Name___________________ Last Name___________________
Type of room requested: Double Twin ( Sharing in a room with 2 twin beds). Triple ( May not be available on all cruises/tours/safari tree lodges)
Sex: M / F Date of Birth (Month/Day/Year, please)_____________
Place of Birth: ________________Citizenship: ____________________
Passport No. ______________________________________________
Date and Place issued:_______________________ Valid until: _____________________
Address____________________________________________________ (No Post Office boxes, please)
Apt No___________ Day Phone ________________ Home Phone ___________________
City _____________State/Province _______ Zip/post code_________
Name of Tour requested:_________________________ DATE OF TOUR:____________
Originating City (for packages that include international air):_____________________ , State:
Emergency contact in the USA: Name : Relationship: Phone:( ) -
Fax: ( ) - E. Mail :
CREDIT CARD :
When using CREDIT CARD: Rates posted on the web do reflect a 4% discount for paying in Cash/check (drawn on a US bank) / Bank wire transfer. When paying by credit card this discount doesn’t apply and the 4 % will be added back in: $.............. Please charge: $................... No later than: mm/dd/yy (Please initial here................)
Charge my credit card: ___Visa ___ Master Card ___ American Express
This is my personal / corporate card: (Please circle one)
Card Number: _____________________________
Expiration Date:
Name as printed on the card: ______________________________
Security code / numbers : ……………….Visa or MC you’ll find these numbers on the back , or AMEX in the front PLEASE fax or mail us legible photo copies of your credit card. BOTH sides please.
Cardholder Signature: _______________________ Date: ___________
I understand that :
"Travel Insurance , is strongly recommended for your upcoming trip.
Please read the brochure for a complete description of important coverage terms, conditions, limitations and exclusions. If you would like more information about travel insurance please call the toll free number listed in the flyer for the Insurance provider .
Acknowledgment:
___Please send me the brochure on Travel Insurance._____No, I am not interested in Travel Insurance and acknowledge that I have been offered, but choose to decline this important coverage. For passengers going on any package that includes the Sahara Caravan in Morocco or Tunisia, must show proof of insurance."
Signature____________________________________
Date_______________________