Ancient Origin & Spiekermann Travel

Tour Reservation & Booking Form
Please complete, sign, date & return along with a clean colored copy of your passport’s 1st page (the one that you intend to use for this specific trip)
Trip Name and Date:*
(Tour name and date)
Traveler #1 Last Name:*
First Name:*
(Name exactly as they appear on passport)
Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone # (Home):

Area CodePhone Number
(Work):

Area CodePhone Number
(Cell):

Area CodePhone Number
Fax:
Email:
example@example.com
Passport #:
(Must be valid for at least 6 month from trip date)
Date of Issue:

MonthDayYear
Date
Place of Issue:
Citizenship:*
Upload a clean copy of your passport:

Browse Files

Cancelof
Marital Status:
Occupation:*
(If retired, previous occupation and company name)
Date of Birth:*

MonthDayYear
Date
Place of birth:*
Are you Vaccinated against COVID-19 (Required by some countries)

YesNo

Traveler #2 Last Name:
First Name:
(Name exactly as they appear on passport)
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (Home):

Area CodePhone Number
Work:

Area CodePhone Number
Cell:

Area CodePhone Number
Fax:
E-mail:
example@example.com
Passport #:
(Must be valid for at least 6 month from trip date)
Date of Issue:

MonthDayYear
Date
Place of Issue:
Citizenship:
Upload a clean copy of your passport:

Browse Files

Cancelof
Marital Status:
Occupation:
(If retired, previous occupation and company name)
Date of Birth:

MonthDayYear
Date
Place of Birth:
Father's First Name:
(This is required for some visa applications)
How did you hear about us:
Person to be notified in case of Emergency
Name & Relationship:*
Phone #:*

Area CodePhone Number
Describe any Health Problems:
Food/Dietary Restrictions:
(By signing for this trip, I admit and confirm my full understanding of the nature of the tour and the physical requirements to be able to keep up with the pace of the visits and the sightseeing and that I am not in any way going to cause delays to the tour group or its other fellow members and if I cause so, I could be denied participation in the tour)
Accomodation
Would like to share room:

YesNo
Please try to assign me a roommate:*

YesNo
I’ll share accommodations with:
(Name)
I need a single occupancy room:*

YesNo
(Single accommodations may be available at an additional cost. Single travelers for whom roommates are not available are subject to single supplement charges)

Air Booking (Airline tickets are not included in any of our tours)
I will do my own international air:
I want STS to help me book my ticket (Extra Cost as the International air is not included in the tour):

Please contact our office for the air reservation assistance.
Notes:
* Depending on airline policy, air ticket may be unchangeable/nonrefundable after issue)
* Seat assignment based on availability … Airlines have many convoluted rules regarding fares that allow (or not allow) mileage accrual and STS is NOT responsible in any way for such matters.
Payment
$750.00 deposit per person is required to process your reservation, unless specified differently on the particular tour brochure you are signing up for.
Balance is usually due 60 days prior to departure unless otherwise specified.
Form of Payment:
Pay by credit card
Check Enclosed by regular mail:
Check Enclosed by regular mail:
https://www.payerexpress.com/ebp/SpiekermannT/
Deposit in the amount of:
(if different than $750) for this tour
Credit Card #:
Expiration Date:
Security Code:
(The 3 digit code next to the signature on the back of the card or 4 digit code on the front right side {AMEX})
Signature for credit card charge:

Clear
Signature for credit card charge:

I would like to authorize STS to charge further payments and balance of my trip on the same credit card depicted above, when the due date comes up
Signature

Clear

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