Full names:

*

Email (very important!):

*

Postal address:

Telephone (very important!):

*

Would you like us  to call you?
If yes, what time?

*

Country of residence:

Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaidjan Bahamas Bahrain Banglades Barbados Belarus Belgium Belize Benin Bermuda Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian O. Terr. Brunei Darussalam Bulgaria Burkina Faso Burundi Buthan Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep. Chad Chile China Christmas Island Cocos (Keeling) Isl. Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Czechoslovakia Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Estonia Ethiopia Falkland Isl.(Malvinas) Faroe Islands Fiji Finland France France (European Ter.) French Southern Terr. Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain (UK) Greece Greenland Grenada Guadeloupe (Fr.) Guam (US) Guatemala Guinea Guinea Bissau Guyana Guyana (Fr.) Haiti Heard & McDonald Isl. Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakstan Kenya Kirgistan Kiribati Korea (North) Korea (South) Kuwait Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (Fr.) Mauritania Mauritius Mexico Micronesia Moldavia Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherland Antilles Netherlands Neutral Zone New Caledonia (Fr.) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Isl. Norway Oman Pakistan Palau Panama Papua New Paraguay Peru Philippines Pitcairn Poland Polynesia (Fr.) Portugal Puerto Rico (US) Qatar Reunion (Fr.) Romania Russian Federation Rwanda Saint Lucia Samoa San Marino Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa Soviet Union Spain Sri Lanka St. Helena St. Pierre & Miquelon St. Tome and Principe St.Kitts Nevis Anguilla St.Vincent & Grenadines Sudan Suriname Svalbard & Jan Mayen Is Swaziland Sweden Switzerland Syria Tadjikistan Taiwan Tanzania Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor outlying Isl. Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis & Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe *

Number of Adults (over 12 years of age):

--None-- 1 2 3 4 5 More than 5 adults *

Number of Children (under 12 years of age):

--None-- 1 2 3 4 5 More than 5 children *

Type of Tour, Safari, Holiday or Excursion:

Birdwatching Tour. Bargain Birdwatching Tour. Wildlife Safari and Holiday. Bargain Wildlife Safari. Photography Tour. Migration Safari. Gorilla Expedition. Chimpanzee Expedition. Beach Holiday. Mt. Kenya Expedition Mt. Kilimanjaro Expedition Walking Safari Cultural Expedition. Family Holiday. Sport Safari. Camping, Guest Houses, Homes and Villas Safari. Business & Incentive Travel Fly-in Safari. Celebration Safari. Day tours & Excursions Self Drive Holidays. Private Group Travel. Safaris & Accommondation Offers. Create my private safari *

How would you like to travel:

Private Safari (you and your partner, friends or family) In a small group (max 6 persons) In a group (Min 6 persons, Max 12 person) As per the Itinerary *

Preferred type of accomondation:

Simple bush camps Eco hotels, lodges & camps Safari hotels, lodges & camps Beach hotels & resorts Exclusive luxury tented camps Exclusive beach villas Boutique hotels & beach lodges Home stays, private villas & guest houses Mid-range hotels, camps & lodges Self catering accommondation Luxury camping Basic camping Not Particular. As per the itinerary *

Special requirements:

Special Diet. Physically Challenged. None.

Preferred mode of transport:

4x4 - Private. 4x4 - Shared. Minibus - Private. Minibus - Shared. 4x4 - Self drive. Scheduled Air Charter. Private Air Charter. Not particular. As per the Itinerary.

Response needed by:

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Estimated budget for your tour / holiday (Includes, accommodation, 4x4 safari vehicle, game drives, park fees & internal flights while on safari. Excludes international flights and anything personal)

Less US $ 1,000 per person Up to US $ 2,000 per person US $ 2,000 - US $ 3,000 per person US $ 3,000 - US $ 4,000 per person US $ 4,000 - US $ 5,000 per person US $ 5,000 - US $ 6,000 per person US $ 6,000 - US $ 7,000 per person US $ 7,000 - US $ 8,000 per person Above US $ 8,000 per person As stated in the Itinerary *

Preferred date of arrival:

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 January February March April May June July August September October November December 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 *

Preferred date of departure:

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 January February March April May June July August September October November December v *

Length of safari:

1 week 2 weeks 3 weeks 4 weeks 5 weeks More than 5 weeks As per the itinerary Not decided *

Country of Destinantion:

Kenya Uganda Tanzania Rwavnda Ethiovpia*

Comment, questions, special request or instructions (May include tentative dates of safari if not sure, how many rooms you require, Preffered language of your guide, Is this trip for a special occasion? If so, what is the occasion? What is most important to you about your upcoming trip?, Interests? )