Date:

INTOURIST USA requires that all travel requests be submitted in writing.
Individuals listed below request INTOURIST USA to act as agent in reserving the following services.

A. Passenger information. Traveling party will include the following persons:

Last name		First name
1
2
3
4
5
6

B. Departure date from the USA:

C. Destination arrival and departure information:

Arrival date:		Arrival City:
Flight No. or train/ship/car:		From where:
Departure date:		Departure City:
Flight No. or train/ship/car:		To where:

D. Tour requested Tour date
E. Please book travel services in the country of
F. Upon arrival/departure in/out each city transfers to/from hotel are required
Yes
No

G. Accommodations & Transportation requested

City	Hotel name	Dates (in)	(out)
1.
Transportation from City 1 to City 2: air, train, car Date
2.
Transportation from City 2 to City 3: air, train, car Date
3.
Transportation from City 3 to City 4: air, train, car Date
4.
Transportation from City 4 to City 5: air, train, car Date
5.
Transportation from City 5 to City 6: air, train, car Date

Type of accommodations
Deluxe
First Class
Single
Twin

Class of rail transportation
First Class
Second Class
Sitting Class

H. Sightseeing preferences & services
City and Date:

I. Visa Information
INTOURIST USA is requested to process visas:
Yes No
Only visa support document is requested to process own visas:
Yes No

J. Travel insurance requested
Yes No

K. Deposit check in the amount of $ is mailed on
A $250.00 deposit per person is required to be paid by check or money order (credit cards are not accepted at this time) to INTOURIST USA at the time of booking. A modification fee will apply if any of the above information will be changed. INTOURIST USA Terms and Conditions have been read, understood and accepted.

L. Personal information of Applicant or Agent
Name (last) , (first) , (middle)
Agency Name

Address:
Street ,
City ,
State , Zip code
Phone (home) , (work)
Fax
E-mail