Airport of departure:     Airport you will fly back to (if different from departure) :

 Coach   or Business class

 Number of persons:

 Date of departure MM/DD Return MM/DD   Number of nights

 Hotel in Paris - Number and type of rooms:  Double (1 bed)     Twin (2 x 1 pers. beds)      single (1 bed)

 Price range per room/night (in US$, all taxes included)

• <$150         
• $150 -$220    
• $220 -$350    
• $350 and above

 Would you like to add  a visit to:

• Normandy    
• Provence    
• Loire Valley
• Alsace      
• Other region

 How many days would you like to spend in this region

 Travelers names (as spelled in passport - IMPORTANT)

 #1 First Last

 #2 First Last

 #3 First Last

 #4 First Last

 Email address (to receive your quote): Telephone