Q 1: First Name

Q 2: Surname

Q 3: Date of birth

Q 4: Best contact Telephone number:

Q 5: Departure date:

Q 6: Return Date:

Q 7: Where are you travelling to (Include country and town/ village or area):

Q 8: Tell me more about your destination area (Tick the one which applies to you)

Q 9: What type of accommodation would you be staying in? (Tick the one(s) which applies to you:

Q 10: Do you have travel insurance? or are you planning to get travel insurance before you travel?