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	BOOKING FORM
If you would like to make a booking for the  "7 Day Western Wanderer", please fill in the details below to submit electronically.

* = required information
*Client Name/s	Title                    (if other please specify below) --Select One-- Mr Miss Mrs Ms Mr and Mrs Other
Client Name/s	Title                    (if other please specify below) --Select One-- Mr Miss Mrs Ms Mr and Mrs Other
*Preferred departure date:       18th February 2010        SOLD OUT       25th March 2010            SOLD OUT 21st February 2011 21st March 2011	*Room Requirements Single Twin Double
*Would you like to book the optional activity whilst on the tour? West Coast Wilderness Railway - Additional $111.00 per person    Yes                  No
*Client Address 1 Client Address 2 Suburb
*City                                                            *State                                   *Postcode
*Client Phone	Client Facsimile
Your E-mail
Special Requests (e.g. non-smoking, ground floor, additional rooms)
You have now completed the booking form.   To send to Groups Tasmania click on the below "Submit Form" button. Once received Groups Tasmania will process your booking request and send a confirmation back to you by the end of the next working day.   Thank you for booking with Groups Tasmania.   Groups Tasmania preferred agents, please enter your Agent Registration Number here:

Contact Information
Phone:       +61 3 6344 9909 Freecall:     1800 462 827 (Australia) Facsimile:  +61 3 6344 9918 Email: info@groupstasmania.com.au	12 Nichols Street Kings Meadows Tasmania 7249