Information Request Form

Newmans Vacations - Travel Agent Booking/Quotation Form

Vacation Description

Vacation Type:

Tour Name:

Tour Code (if applicable):

Hotel Standard:

Room Type:

Is this your client's first trip to the South Pacific?:

yes no

What countries would your client like to visit during this trip?

Australia	New Zealand

Pacific Islands
Fiji	Tahiti
Cook Islands	Samoa
Tonga	Vanuatu
Papua New Guinea

Asia
Bali	Japan
Thailand	Malaysia
China	Singapore
Hong Kong	Cambodia
India	Vietnam

Description/Comments:

Flight Information

Departure City:

Preferred Departure Date:

Preferred Return Date:

Client Information

Name(s) (as they appears in their passport):

Number of Adults:

Number of Children:

Ages of Children:

Contact Information

Agency Name*:

IATA/ARC*:

Consortium* (place N/A if not affiliated):

Travel Agent Name*:

Address 1*:

Address 2:

City*:

State*:

Zip Code*:

Phone Number*:

Fax Number:

Email*:

I would like to receive information about Newmans Travel Deals:

(Please note: Your personal information will remain confidential at all times and will only be used to update you on our products and services. We respect your privacy)

Additional Information

Please contact me by:

Best time to call:

Comments/Questions

For additional information or to book please contact your local travel agent or:

Newmans Vacations
300 Continental Blvd, Suite 350
El Segundo, CA 90245

Tel: 800-342-1956
Fax: 310-215-9705
newmans@newmansvacations.com