Custom Vacation Reservation Request

Vacation Information	Note: Fields marked with * are required.
Departure City:*	Auckland (AKL) Los Angeles (LAX) Paris (CDG) Sydney (SYD) Tokyo (NRT)
Departure Date:*	January February March April May June July August September October November December   01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   2009 2010
Would you like a quote for your international air travel?*	Yes   No
Number of Nights:*
Number of Adults:*
Number of Children:* (under 12 yrs)
Children's Ages: (under 16 yrs)	0-11 mo. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 0-11 mo. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 0-11 mo. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 0-11 mo. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 0-11 mo. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 0-11 mo. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
	You must enter Children's Ages if you are traveling with children, it is required for the quote. If traveling with more than 6 children, please enter ages in Additional Information below.
Honeymoon?	(Special discounts and/or amenities may apply)
Wedding Anniversary?	(Special discounts and/or amenities may apply )
If yes, what Anniversary are you celebrating? (required to check for Anniversary discount/amenities eligibility)	(enter # of years)
What is the Anniversary date? (required to check for Anniversary discount/amenities eligibility)	/ /
Budget Per Person:*	under $1000 $1000 to $2000 $2000 to $3000 $3000 to $4000 $4000 to $5000 $5000 to $6000 $6000 to $7000 $7000 to $8000 $8000 +
Island Preferences: (Choose as many as you'd like)	Tahiti Moorea Bora Bora Huahine Tahaa Raiatea Rangiroa Manihi Tikehau Hiva Oa Nuku Hiva
Hotel Preference:*	Deluxe (5 Star) First Class (4 Star) Moderate (3 Star) Standard (2 Star) Budget (1 Star)
Additional Information: Please enter any special requests, Email Specials or interests you may have, or ask us a question.
Optional Daily Meals
Daily American Breakfast: If desired, select the number of days on each island you would like this meal added to your vacation.	# Days: 1 day 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 days 12 days 13 days 14 days 15 days 16 days 17 days 18 days 19 days 20 days 21 days 22 days 23 days 24 days 25 days 26 days 27 days 28 days 29 days 30 days	Island: Tahiti Moorea Bora Bora Huahine Tahaa Raiatea Rangiroa Tikehau Manihi Nuku Hiva Hiva Oa
	# Days: 1 day 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 days 12 days 13 days 14 days 15 days 16 days 17 days 18 days 19 days 20 days 21 days 22 days 23 days 24 days 25 days 26 days 27 days 28 days 29 days 30 days	Island: Tahiti Moorea Bora Bora Huahine Tahaa Raiatea Rangiroa Tikehau Manihi Nuku Hiva Hiva Oa
	# Days: 1 day 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 days 12 days 13 days 14 days 15 days 16 days 17 days 18 days 19 days 20 days 21 days 22 days 23 days 24 days 25 days 26 days 27 days 28 days 29 days 30 days	Island: Tahiti Moorea Bora Bora Huahine Tahaa Raiatea Rangiroa Tikehau Manihi Nuku Hiva Hiva Oa
Canoe Breakfast: (Overwater Bungalow stays ONLY) If desired, select the number of days on each island you would like this meal added to your vacation.	# Days: 1 day 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 days 12 days 13 days 14 days 15 days 16 days 17 days 18 days 19 days 20 days 21 days 22 days 23 days 24 days 25 days 26 days 27 days 28 days 29 days 30 days	Island: Tahiti Moorea Bora Bora Huahine Tahaa Raiatea Rangiroa Tikehau Manihi
	# Days: 1 day 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 days 12 days 13 days 14 days 15 days 16 days 17 days 18 days 19 days 20 days 21 days 22 days 23 days 24 days 25 days 26 days 27 days 28 days 29 days 30 days	Island: Tahiti Moorea Bora Bora Huahine Tahaa Raiatea Rangiroa Tikehau Manihi
	# Days: 1 day 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 days 12 days 13 days 14 days 15 days 16 days 17 days 18 days 19 days 20 days 21 days 22 days 23 days 24 days 25 days 26 days 27 days 28 days 29 days 30 days	Island: Tahiti Moorea Bora Bora Huahine Tahaa Raiatea Rangiroa Tikehau Manihi
Contact Information
First Name:*
Last Name:*
Country of residence:*
Home Phone:	( )
Work Phone:	( )
E-mail:*
Would you like to subscribe to our email newsletter?	Yes   No
How did you hear about us?*	Tahiti & French Polynesia Guide, Jan Prince Moon Handbooks Tahiti, David Stanley Yahoo Google MSN The Knot Wedding Channel Modern Bride Trip Advisor Tahiti Tourisme ISLANDS Magazine David Stanley's South Pacific.org InterContinental Resort web sites Moorea Tattoo Aesthetics Worldwide AOL Excite Referred by a friend Other
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