Please fill out your form and press the print button at the bottom of the page.

Title:

 

 

Surname:

First or preferred name:

Date of Birth:
(dd/mm/yy)

Address:

 

Number or house name:

 

Street:

 

Village or Town:

 

County/State:

 

Postcode/Zip:

Country:

 

Home Tel/Fax No.:

e-mail address:
@

 

Please reserve me place(s) on your holiday.

If possible I would like to fly from:

Manchester

... to  connect with the main hub of Heathrow and Gatwick (Please tick your  preferred choice or leave blank).

 

Leeds/Bradford

 

Glasgow

 

Newcastle

 

Birmingham

  Edinburgh

Accommodation required: Single Twin Double

I would be prepared to share in twin-bedded accommodation: YES NO

What type of passport do you hold?

Passport Number:

Expiry Date: (dd/mm/yy)
Please note that your Passport must have at least 6 months to run after the return date of your holiday.

I/we hold an annual/single trip insurance policy with:

Expiry Date : (dd/mm/yy)

Policy No. (Please forward a copy of your insurance Policy to us)

Do you have any special dietary requirements?

Is there any food that you dislike?
(This will help when contacting Hotels)

Have you any food and/or other allergies? YES NO
(If YES please give brief details below)
 

Have you any pre-existing Medical conditions? YES NO
(If YES please give brief details below)
 

Where did you hear about Birdwatching Breaks?

 

I wish to pay by Credit card:

Please deduct a deposit of £ with the balance payable as quoted in your  Terms & Conditions.

 

Visa /Mastercard /Delta

 

Card No. :

 

Start date:

Expiry date:
Security Number:
American Express
Look for the 4-digit code printed on the front of your card just above and to the right of your main credit card number. This 4-digit code is your card security code.
Visa/Mastercard
Flip your card over and look at the signature box. You should see either the entire 16-digit credit card number or just the last four digits followed by a special 3-digit code. This 3-digit code is your card security code.

I wish to pay by Cheque:

I enclose a cheque for the sum of £

I have read and fully understand the

   
Postal submissions may be sent to: Mark Finn,
Birdwatching Breaks,
Cygnus House,
Gordons Mill,
Balblair
Ross-shire
IV7 8LQ
Scotland

If paying by cheque, please make your cheques payable to Birdwatching Breaks.

Please Fax submissions to: +44 (0) 1381 619452

If you have any further queries regarding bookings please call:
+44 (0) 1381 610495 or e-mail :m.finn@birdwatchingbreaks.com

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