Booking Form

Name/Code of the trip/expedition :

Departure Date :

Full name(s) :

Sex (Male/Female) :

Date / place of birth :

Nationality :

Passport No. :

Date of expiry :

Country of Residence :

Private phone :

Mobile phone or other :

E-mail / fax :

Address :

Experience in previous expeditions or your last trip :

Are you a vegetarian or have other special dietary needs?

I have read the Terms and Conditions
(http://www.antarctic-company.com/terms-and-conditions.htm)
of TAC and agree to abide by them.

Date ____-____-_______ 

Signature _________________