Terzis Travel - Health Tourism

TERZIS TRAVEL
17, Ethnikis Antistaseos Street,
Corinthos 20 100, Greece

Tel: ++30 27410 71710
Tel: ++30 27410 80350
Tel: ++30 27410 71710
Fax: ++30 27410 23388

E-mail: info@terzis-travel.com

HEALTH TOURISM - RESERVATION FORM

Please can you complete the short form below in order for us to proceed with the reservation for your Health Tourism Package. Items marked with a * are required, and the form cannot be sent unless these items are filled in.

When filling in the form below, please can you try to fill in as much of the information as possible (or as needed) in order to make your reservation as efficiently as possible.

On receipt of this form, we will send you a confirmation letter stating Total Payment, Payment Conditions, Cancellation Policy and our Confirmation Number.

:: INDIVIDUAL'S INFORMATION
( Personal Data is Protected by Greek Law )
No Name change is allowed after confirmation of booking

Family Name: *

Forename: *

Address: *

Postcode: *

City: *

Country: *

Nationality: *

Telphone Number: *

Fax Number:

E-Mail Address: *

Mobile Number :
( For Emergency Reasons )

:: I Wish To Participate in the Following Packages .......

:: RELAXATION PACKAGES

Program Code: ( Please Tick )	P5.1	P5.2	P5.3	P5.4	P10.1	P10.2
Number of Persons:
Starting Date: ( dd/mm/yy )

:: INVIGORATION PACKAGES

Program Code: ( Please Tick )	P4.1	P4.2	P4.3	P6.1	P10.3
Number of Persons:
Starting Date: ( dd/mm/yy )

:: THERAPEUTIC PACKAGES

Program Code: ( Please Tick )	T.1	T.2	T.3	T.4	T.5	T.6
Number of Persons:
Starting Date: ( dd/mm/yy )

:: SPECIAL OFFERS

Program Code: ( Please Tick )	H1	H2	H3	H4	H5	H6
Number of Persons:
How Many Times: ( Eg: 5 )
Dates From - To: ( Eg: 01-05/06/04 )

Additional Comments:

:: PAYMENT METHOD
	Bank Transfer	Cheque	Credit Card

** EARLY RESERVATION IS HIGHLY RECOMMENDED **

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