Easy
Life
Fax Inquiry / Booking
to: Easy Life Tours & Rentals Australia
att. Pia
Phone: 0061 7 5494 7961
Fax: 0061 7 5406 0958
Email: pia@easylife.net.au
from: phone:
fax/email:
Where
did you get our address from?
Please
send an offer: [ ] a
contract: [ ]
vehicle:
EMU2 or EMU3 (2 and 3-berth camper), EMU4 or EMU6 (motorhomes), B2B
(campervan), BUSHKANGAROO (4WD-camper),
Period from: to:
Pick
up: Drop
off:
Cover options [ ] CDW [ ] CC
Number of adults: children: age of children:
Special
needs:
Date of arrival: flight
no: time: airline:
Date of departure: flight
no: time: airline:
Surname: first
name:
Address:
Date of birth: attainable
till:
Phone No: Fax
No or e-mail:
Passengers name & date of birth:
deposit payable by: bankaccount [ ] creditcard
[ ]
the balance: bankaccount [ ] creditcard
[ ] cash
[ ] A$
traveller cheques [ ]
Mastercard |_| Visa |_| Name on card:
Card no. |_|_|_|_| |_|_|_|_| |_|_|_|_|
|_|_|_|_|
exp. date: |_|_|
/ |_|_|
ver. code: |_|_||_|
(last 3 digits on signature strip on back
of card)