PRINTABLE APPLICATION FORM

FAX/MAIL-IN APPLICATION FORM

Image Quest Photographic Adventures

4967 Bridge Street, Soquel, CA 95073
Phone:(831) 475-1677 Fax: (831) 476-7051
eMail: apply@imagequestadventures.com

1. Name (as in passport) ___________________________
Occupation ______________________________

Passport Number ___________________ Nationality _______________________
Age _______ Sex _____

Street Address _________________________________________________

City ______________________________ State _____ Zip ___________

2. Name (as in passport) ___________________________
Occupation ____________________________

Passport Number ___________________ Nationality _______________________
Age _______ Sex _____

(If different from above) Street Address _________________________________________________

City ______________________________ State _____ Zip ___________

Phone (home)___________________(work) __________________
Fax _____________

In case of emergency, please notify.
Name __________________________________Relation ____________

Address _________________________________
Phone _________________________________

I/We wish to book the following trek:
__________________________________ Dates __________________

Air Transportation

All Image Quest Photographic Adventure Tours originate and terminate from Seattle, Washington. Tour members are expected to be in Seattle on the day of or prior to the departing flights to Alaska. Full flight itineraries will be sent upon acceptance of deposit. Image Quest Photographic Adventures can assist you in your flight reservations to help you insure that you will be at your destination in time for flight departures to Alaska.

Please arrange air transportation from:
_________________________________ and return to
_____________________________

I would like to use a credit card (AX, MC,VISA) to pay for the following:
____air tickets ____application deposit ___full Land Cost when due

Card Number ___________________________________ Expiration Date __________

I am willing to share a double room ___ With a Smoker ____Non-smoker___ Either ____

_____I prefer a single room and am willing to pay the supplemental cost

How did you hear of Image Quest Photographic Adventures?
_______________________________________________________________________________

Please describe your health and photographic background
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Thank you. Someone will contact you from Image Quest Photographic Adventures as soon as your application has been received.

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