READY TO TRAVEL? G H A  has provided this easy form to get you started. Our travel consultants will process your information within 24 hours to create a customized itinerary, and will work with you personally to finalize your plans.

Last Name (as it appears on your  passport)

First Name (as it appears on your passport)

Street Address

City

State

Zip Code

Telephone

Fax

E-mail

DESTINATION # 1

DEPARTURE CITY

TRAVEL START DATE

ARRIVAL CITY / DESTINATION

TRANSPORTATION

Rental Car Limo Transfer Other None Japan Rail Pass

ACCOMMODATIONS / NO. OF NIGHTS

Type Hotel Motel Resort Condo Villa Other Nights 1 2 3 4 5 6 7 Other

SPECIAL REQUESTS - Airline, car and hotel preferences. Special tours and excursions at your destination. This is limited only to your imagination.

ARE YOU FINISHED?  Yes No

If yes, complete your return date below. If not, continue on to Destination # 2.

RETURN HOME DATE

DESTINATION # 2

TRAVEL DATE TO DESTINATION NO. 2

ARRIVAL CITY / DESTINATION

TRANSPORTATION

Rental Car Limo Transfer Other

ACCOMMODATIONS / NO. OF NIGHTS

Type Hotel Motel Resort Condo Villa Campground Nights 1 2 3 4 5 6 7 Other

SPECIAL REQUESTS - Airline, car and hotel preferences. Special tours and excursions at your destination. This is limited only to your imagination.

TIME TO GO HOME NOW?   Yes No

If yes, complete your return date below. If not, complete the freeform space below with details about the remainder of your journey.

RETURN HOME DATE

FINAL COMMENTS AND OTHER DESTINATIONS...