Questionnaire

In order for us to produce a tailor-made holiday for you, please answer the questionnaire as fully as possible and submit it to us.

Please indicate number of people here
1 2 3 4 5 6 7 8 9 10
1. Full Name.	Date of birth.
2. Choice of Itinerary/Tour.
Itinerary 1 Fixed Departure Itinerary 2 Fixed Departure Itinerary 3 Fixed Departure Itinerary 4 Fixed Departure Selected tour Northern Peru Selected tour Southern Peru Selected tour Peru off-the-beaten-track Selected tour Peruvian Highlands Special interest Ancient civilisations Special interest Peru train journeys Special interest Birding around Peru Special interest Escorted birding in Manu Special interest Women-only tours Special interest Wildlife in Northern Peru Special interest Wildlife in Southern Peru Special interest Fishing tours Special interest Vivencial Huaraz Special interest Special needs Special interest Luxury honeymoon Special interest Discounted Student tour Luxury tour 1 Luxury tour 2 Luxury tour 3 Luxury tour 4 Tour extensions Inca Trail Tour extensions Cuzco/Machu Picchu Tour extensions Titicaca Lake Tour extensions Arequipa/Colca canyon Tour extensions Ballestas/Nazca Tour extensions Tambopata Tour extensions Kuelap Tour extensions Huaraz Tour extensions Trujillo/Cajamarca Tour extensions Lambayeque museums Tour extensions Manu Tour extensions Amazon cruise Tour extensions Unknown Peru Tour extensions Tumbes/Mancora Tour extensions Trips around Lima Tour extensions Colan beach Tailor-made tours - Build your own Adventure tours Rockclimbing Adventure tours Horseriding Adventure tours Mountainbiking Adventure tours Rafting Mountaineering & Trekking - Inca Trail Mountaineering & Trekking - Choquequirao trek Mountaineering & Trekking - Lares valley trek Mountaineering & Trekking - Santa Cruz trek Mountaineering & Trekking - Alpamayo trek Mountaineering & Trekking - Huayhuash trek Mountaineering & Trekking - Kuelap Inca Trail Mountaineering & Trekking - Colca trek Mountaineering & Trekking - Cotahuasi trek Mountaineering & Trekking - Volcano valley trek Mountaineering & Trekking - Origin of the Amazon trek Mountaineering & Trekking - Llama trek Mountaineering & Trekking - Torres del Paine trek Mountaineering & Trekking - Ishinka climb Mountaineering & Trekking - Cotopaxi climb Mountaineering & Trekking - Aconcagua climb Mountaineering & Trekking - Pisco climb Mountaineering & Trekking - Misti climb Mountaineering & Trekking - Huascaran climb Mountaineering & Trekking - Alpamayo climb Fixed Departure Santa Cruz Trek Fixed Departure Ishinka Climb Fixed Departure Huascaran Climb Fixed Departure Alpamayo Climb Fixed Departure Llama Trek Fixed Departure Alpamayo Trek Fixed Departure Huayhuash Trek Fixed Departure Torres del Paine Trek Fixed Departure Cotopaxi Climb Fixed Departure Aconcagua Climb Itinerary 7:Peru and Bolivia Itinerary 8:Peru and Ecuador Itinerary 9:Peru and Brazil Itinerary 10:Peru and Chile Itinerary 11:Peru and The Galapagos Islands Itinerary 12:2005 Christmas in Machu Picchu Itinerary B1:Amazing Brazil Itinerary B2:Wild Brazil Itinerary B3:Historical Brazil Itinerary B4:Wonders of Brazil Itinerary B5:Beaches of Brazil Itinerary Chile 1 Itinerary Chile 2 Itinerary Chile 3 Itinerary Chile 4 Itinerary Chile 5 Chile Atacama extension Chile Easter Islands extension Chile Santiago & Viña del Mar extension Chile Lake District extension Chile Torres del Paine extension Chile Torres del Paine & Glaciers extension Chile Chiloe Island extension Chile Ushuaia cruise extension Chile Kaweskar explorer's extension Chile Patagonian channels ferry extension Itinerary BO1:Essential Bolivia Itinerary BO2:La Paz & Uyuni Salt Lakes Itinerary BO3:La Paz & Rurrenabaque Itinerary BO4:Historical Bolivia Itinerary E1:Quito & The Galapagos Islands Itinerary E2:Colonial Ecuador Itinerary E3:Whale Watching Itinerary E4:Ecuador Adventure Itinerary E5:Andes to Amazon Itinerary A1:Amazing Argentina Itinerary A2:Southern Lakes Itinerary A3:Northwest Argentina Itinerary A4:Wildlife and Glaciers Itinerary A5:Patagonia Costa Rica Panama Honduras Mexico Caribbean Islands
3. Please indicate any specific interests you may have :
<<None of the below>> Ancient civilisations Climbing and Mountaineering Less active sightseeing Walking and Hiking Wildlife Bird-watching Horse riding Skiing Sea-kayaking A Combination of these
4. Please indicate whether you have any specific requests, suggestions or trip requirements.
5. Proposed start date.	Proposed end date.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2005 2006 2007 2008 2009 2010	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2005 2006 2007 2008 2009 2010
6. If building your own itinerary, please indicate length of tour requested :
<<Not applicable >> 1 to 10 days 10 to 15 days 15 to 20 days 20 to 25 days 25 days+
7. Please indicate if you would like further information on any of the following tours. If you have any specific mountain or location in mind then please ask.
<<None of the below >> Exploring southern Peru - 8 or 10 days Exploring Brazil - 10 - 31 days Bird-watching - 10 or 14 days Llama trekking - 7 days Hiking the Inca trail - 4 days Wonders of Peru - Tour of Peru - 31 days Trekking in the Colca canyon - 4 days Trekking along Cordillera Huayhuash - 14 days Trekking to Alpamayo via cedars gorge - 9 days Trekking in the Cordillera blanca - 4 days 4x4 driving adventure - 6 days Climbing Mt Pisco. Non-technical - 11 days Climbing Mts Pisco and Huascaran. Technical - 16 days Climbing Mt Alpamayo. Technical - 13 days Climbing Mts Ishinka and Tocllaraju. Non-technical - 12 days Climbing Mt Yerupaja.Technical - 19 days Climbing Mt Rondo.Technical - 10 days More about Bolivia More about Ecuador More about Brazil More about Chile More about Argentina The Galapagos Islands
8. Contact Name and Address Name Dr. Mr. Mrs. Miss. Ms. Address including postcode Country Telephone E-mail