Email Address  *

First & Last Names  *

Business Phone Number  *

Fax Number

Mobile Number  *

Number of Children/ Youth  *

School Grade

Age group or Range

Time of Arrival at Venue  *

Date of Departure from Venue  *

Time of Departure from Venue  *

Type of Venue / Accommodation  *

Star Rating if Hotel or Lodge type?  *  None   1 *   2 **   3 ***   4 ****   5 ***** 

Rooming Single or Shared  *

Activities/ Program Required  *

Facilitator to Learner Ratio  *

Preferred Area / Province for Event  *

Travelling from where / home base?

Transport required - yes or no?  *

First meal required after arrival  Breakfast   Lunch   Supper 

Last meal required prior to departure  Breakfast   Lunch   Supper 

Budget  *

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