Personal Details
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Trip Details
How many people are traveling ?		1 2 3 4 5 6 7 8 9 10 or more
Will you travel with children ? How many will be ? How old are they (separate with commas) ?		YesNo 1 2 3 4 5 6 7 8 9
Which country will you travel to ?		Bhutan Cambodia China India Nepal Tibet Vietnam
Date of anticipated travel		< February 2012 > Su Mo Tu We Th Fr Sa 29 30 31 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 1 2 3 4 5 6 7 8 9 10
How many days do you plan to travel ?
Which cities would you like to visit ? (one city per line)

Preferences
What modes of transportation do you prefer for in-country travel ? (select all that apply)		AirplaneBicycle Car/BusOther Train
What are you interested in ? (select all that apply)		CultureMuseum HistoryRiver Cruise Natural SceneryDiscovery ArchitectureWalking
What type of holiday ?		Adventure Culinary Education Family Golf Social Club Other
What type of accommodation do you prefer ?		3* standard hotel 4* superior hotel 5* deluxe hotel
Would you like us to include any meals in your itinerary ? (select all that apply)		Breakfast Lunch Dinner
How did you hear about us ?		Travel show Get Up & Go magazine Holiday with Kids magazine Vacation & Travel magazine Saturday Sydney Morning Herald Web (search engine) Referral Travel agent Other
Any special requirements ?
Please email me special offers, travel information and Selective Tours monthly newsletter		YesNo
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