Charities Enquiry Form

Name of Charity:

Charity Ref:

Destination:

Lead Name:

Wish child:

Contact details

Address:

Phone number:

Email:

Wish granter:


Passenger information (all details should be as per passport)
all passport information is mandatory for all passengers in order for us to process a booking

Passenger 1

Title:

First Name:

Middle Name:

Surname:

Date of birth:

Document type:

Document number:

Expiry date:

Country of issue:

Nationality:

Gender:


Passenger 2

Title:

First Name:

Middle Name:

Surname:

Date of birth:

Document type:

Document number:

Expiry date:

Country of issue:

Nationality:

Gender:


Passenger 3

Title:

First Name:

Middle Name:

Surname:

Date of birth:

Document type:

Document number:

Expiry date:

Country of issue:

Nationality:

Gender:


Passenger 4

Title:

First Name:

Middle Name:

Surname:

Date of birth:

Document type:

Document number:

Expiry date:

Country of issue:

Nationality:

Gender:


Passenger 5

Title:

First Name:

Middle Name:

Surname:

Date of birth:

Document type:

Document number:

Expiry date:

Country of issue:

Nationality:

Gender:


Passenger 6

Title:

First Name:

Middle Name:

Surname:

Date of birth:

Document type:

Document number:

Expiry date:

Country of issue:

Nationality:

Gender:


I confirm that all the information provided is correct.

Please remember that if the information is inaccurate or does not match the document presented for travel, the passenger will not be permitted to travel.

If a change of name is required prior to departure we will consult with the travel supplier. If they allow a name change as part of the booking terms and conditions we will process the change. For this service there will be an additional service charge in addition to the change fee requested from the travel supplier.

Special Need information:

Insurance policy details:

Medical condition:

Does the traveller require Wheelchair/buggy?

if Yes, please provide details:

Wheelchair/buggy information:

Does the traveller require special assistance?

if Yes, please provide details:

Additional requirements:

Travel booking details

Departure point:


Destination:

Departure date:

Return date:

Accommodation:

Number of rooms:

Room type:

Special requests:

Authorised cost:

Additional invoicing information:

Email address that confirmation and tickets should be sent to:

I confirm I understand and agree to the booking conditions of John Proctor Travel and the Travel Suppliers used for this booking. I also understand that it is the traveller’s responsibility to ensure valid documents (passports/visas/permits etc) are in place for travel to the final destination.

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