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Please complete the form below and make your payment online (please note: you can also select to make your payment by cheque or bank transfer once you have filled in this form).

A deposit of £180 per activity is required to reserve your place, unless you are travelling within 12 weeks in which case the full payment is required at time of booking. A deposit of 30% is required for all courses and luxury lodge bookings.

To check availability for your chosen activity, or if you have any questions, please either call us on
+44 (0) 117 904 1924 or email us through our enquiry page.

Fields marked with a * are mandatory.

Personal Details

First Name*

Surname*

Telephone number*

Mobile number

Email*

Date of Birth (dd/mm/yyyy)*

Gender*

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Address 1*

Nationality*

Address 2

Passport Number

Town*

Passport Expiry Date (dd/mm/yyyy)

County/State

Status

Country*

Post/Zip Code*

Projects/Activities

PROJECT/ACTIVITY
Type*	Volunteer Project Overland Tour Luxury Lodge Course Adventure Expedition
Product*
Desired Start Date*	(dd/mm/yyyy)	Duration*

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Further Information

Please detail any dietary requirements

Please detail any medical conditions/phobias

Emergency Contact Details

Emergency Contact Name*

Relationship

Telephone Number*

Supporting Information - (for volunteer placements only)

Please tell us what you hope to gain/achieve by taking part in this project

Please describe any skills/personal attributes that may assist you on your project as well as what you currently do

Amanzi Travel

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It is essential that you have read and agree to the terms and conditions which are available on www.amanzitravel.co.uk and can be mailed to you on request.

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Please note: there is a 2.8% charge that will be added to all payments using a credit or non UK debit card.

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