While you may submit this form online, you must also print (click here for a printable version), complete, SIGN, and return this form to 206 Tours at:  

333 Marcus Blvd    -    Hauppauge, NY 11788    -    fax. (631) 361-3682

Cardholder Information

Name

Address

Address

City, State Zip

Telephone

E-Mail

Trip/Traveler Information

Tour or Coordinator

Departure Date

Destination

Traveler's Name

Credit Card Information:

Credit Card

Visa        MasterCard        AMEX         Discover

Credit Card #

Exp. Date

Security Code

Payment Option

 Please charge $400/person deposit Only *

 Please charge $400/person deposit and travelers insurance
 Please charge $400/person deposit now and the balance 60-70 days prior to departure

 Please charge $400 deposit & travelers insurance now and the balance 60-70 days prior to departure
 Please charge total trip cost of 

Comments:

Comments

Refunds via Credit Card are subject to an additional 3.5% service fee.  

Enrollment in and payment of the tour constitutes your acceptance of the 206 Tours Terms & Conditions please note that special departures may be subject to alternate terms and conditions.

Initial Here to Accept Terms and Conditions           

X ____________________________________________             _______________

                                Signature                                                  Date