NAME


COUNTRY


E-MAIL ADDRESS


YOUR AGE BRACKET
35-50 51-65 66-up

Accommodation / creature comfort should be :




Do you like spending some time hiking, walking, rafting, bicycling during your trip?
Yes, to all
Not really
Yes, but only:


Do you enjoy “roughing it” for just one day and maybe one night to obtain a more genuine experience or to get to a more remote and hopefully more rewarding location?
Yes
No

Do you like to engage in certain sports while traveling? (please name your preference, e.g. golf, tennis, diving)
Yes
No

Do you enjoy a morning off during your travel to enjoy relaxing, indulge in a spa treatment or just be on your own?
Yes
No, Thanks

Have you visited the destination of your interest before? If so, we would love to know what sights you definitely do not wish to revisit.


What time of the year do you intend to travel?
Month:


How many days do you have at your disposal for visiting the destination of your interest?


Please explain in your own words what you are looking for and how best we may respond to you:




 

153/22 Ban Siriporn, Moo 8 Nongchom, Sansai, Chiang Mai 50210 / Thailand
Tel: +66 53 351 472 Fax: +66 53 351 474