RESERVATION FORM

PLEASE COMPLETE THE FORM BELOW

All U.S. citizens require a valid passport for travel to Japan with at least three months validity. Please provide the information below to reserve your space on Linda & Sumire's Deluxe Tour of Japan 2016.

Passenger 1: Name as it appears on passport *

Passport Number *

Expiration Date *

Email *

Telephone Number *

Alternate Telephone Number *

Birthdate *

Passenger 2: Name as it appears on passport *

Passport Number *

Expiration Date *

Email *

Telephone Number *

Alternate Telephone Number *

Birthdate *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Airfare is not included in the booking as quoted. Please indicate how you would like to handle your flights: *

I will book my flight to Japan on my own. (Please submit your airline and itinerary as soon as available.) I would like your assistance in booking a flight to Japan from Los Angeles. I understand that air will be in addition to the quoted land only rate. I have not yet decided. I understand that I am responsible for purchasing my flight to Japan separate from the ground tour.

Emergency Contact *

Emergency Contact's Phone Number *

Please identify your Travel Agent *

If only one passenger is indicated above, please select one of the following: *

I would like to stay in a room alone and pay the $1395 single supplement. I would like to consider sharing a room with another passenger. If a suitable room mate cannot be identified, I will pay the single supplement. I will be sharing a room with another passenger who is paying separately. (Please indicate that person's NAME ONLY above under

If you would like to extend your stay in Japan on your own, please provide dates and locations, and any assistance you would like us to provide: *

Please provide any special dietary, medical or physical conditions you and/or your companion may have: *

$500 per person deposit is required at time of booking. Deposits made by October 1, 2015 will receive a $100 discount per person at the time of final payment. Payment in full is due February 19, 2016. An additional $100 discount per person will be awarded when payment in full is received by December 1, 2015. When you click the "submit" button below, you will be redirected to the payment page which will instruct you on how to make payments by check or credit/debit card. A 3% convenience fee will be applied to credit/debit card payments.

Submit

LJoytravel (CST#2111063-40). For more information, contact Linda Gant at (310)941-3344, [email protected] or Sumire Gant at (562)397-7849, [email protected].