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 in France

 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)

• <$130         
• $130 -$200    
• $200 -$300    
• $300 -$500    
• $500 and above

 If possible, 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 (optional)