::: Belair Charter Reservation Request Form :::

Belair Switzerland Travel Agent's Charter Reservation Request Form

Fill out the form below:

1. Contact Information

Travel Agency Name:

* required

Agents Name:

* required

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

* required

Fax:

Email Address:

* required

Communication Preference:

I would like an agent to call me with more information

2. Passenger Information

Please list the full names of all passengers and the birthdates of any child up to and including 15 years old on departure date.
** Names must match passport exactly - any errors will result in a fee to correct **

	First Name	Last Name	Date of Birth	Seating Choice (leave blank for no additional charges)	Sex

#1				window aisle add $50.00	male female
#2				window aisle add $50.00	male female
#3				window aisle add $50.00	male female
#4				window aisle add $50.00	male female
#5				window aisle add $50.00	male female
#6				window aisle add $50.00	male female

3. Date Selections

Please indicate your desired departure and return dates using the drop down selections below:

Select Point of Origin:

Vancouver

Calgary

Zurich

Please select a departure and return date. They can be any combination of the following:
Departure Date :	Return Date:

Notes on your date selections:

4. Options

Check only those choices that apply:
Reserve Seat:	Yes	Cost: $50.00 (You must check this if you reserved a seating choice in SECTION 2)
Relax Class:	Yes	Cost: Add $695.00 per way

UPON RECEIPT OF THIS REQUEST FORM, WE WILL CONFIRM RESERVATION WITH NET FARES