Nubian Nile Cruises, North Africa & East Mediterranean Specialists

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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_______________________