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Online Booking Form



 

Please complete the following booking form.

If you are concerned about giving your credit card details online please see our simple guide to online security
Holiday
Departure Date: * (dd/mm/yyyy)
Number of Nights:
Holiday Destination: *
Departure From:
Name of Accommodation:
Type:
Personal Details
Title:
Surname:
(as on passport) 		*
First Names:
(as on passport)		 *
Date of Birth: (dd/mm/yyyy)
Email: *
Street Address: *
Town/City:
State/County:
Zip/Postal Code: *
Country:
Day Telephone:
Evening Telephone:
Occupation:
Special Dietary Requirements:
Special Medical Conditions:
(leave blank if none)
Travel Insurance Arrangements
Please see our page on Travel Insurance
Do you require Solitair Insurance:
If No, Please State Your Insurers Details:
Policy Number:
Insurer's Telephone Number:
Payment Details
Holidays Cost:
Insurance(£):
Early Booking Advance:
(Minimum £100 if booking 10 weeks before departure)
Extras(£):
Total Payment(£):
I authourise Solitair to deduct the above amount from my credit / debit card. - online security
Card Number: *
(Numbers only, no dashes or spaces)
Card Expiry Date: * *
Card Issue Date:   
Card security no: *
*** (the last 3 digit number on the signature strip)
Card Type:
Issue Number (if switch):
Credit Cards(Visa, Mastercard) subject to 2% surcharge.
Debit Cards (Delta & Switch) no surcharge.
Card Holders Information if not as Above
Card Holders Name:
Street Address:
Town/City:
State/County:
Zip/Postal Code:
Country:
Comments:
A confirmation invoice will be sent as soon as possible. Tickets and Itinearies are dispatched 10 - 12 days prior to departure. Once informed and invoiced, any charges will occur an administration fee. Minimum cancellation charge: Loss of deposit. I have read the terms and conditions and agree that its contents shall form the basis of my contract and I accept the full responsibility for the total cost of this booking.
Name:
Date:
 
 
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