Please use this form every time you make a booking or make any change to an existing booking. This form must be submitted the day you make the deposit with the supplier.
Agent Name * Karen Rybak
New Booking? * YesUpdateCancellation
Booking Date *
Original Booking Date (if this is an update)
Client Name *
Passenger Name (if different)
Supplier/Vendor *
Confirmation Number
Travel Date: Start *
Travel Date: End *
Total Amount
Commission (if provided on the confirmation)
Deposit Date
Deposit Amount
Final Payment Due Date
Balance Due
Daily Rate (hotel)
Number of Nights (hotel)
Booking Method (GDS/Phone/Online) Select One OptionGDSPhoneOnline
Form of Payment (credit card number, no exp date, no security code))
PWP: Y/N NoYes
FHR: Y/N NoYes
Altour: Y/N NoYes
Gold Card Call * NoYes
Destination
Additional Comments
1 + 2 = ? Please prove that you are human by solving the equation *