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Page 1 of 2. Hello Ireland Programme: Agency Booking Form 2012. Agency Details. Agency Name Contact Person Address: Town Country Post Code Where did you hear about Hello Ireland? .
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Page 1 of 2 Hello Ireland Programme: Agency Booking Form 2012 • Agency Details Agency Name Contact Person Address: Town Country Post Code Where did you hear about Hello Ireland? • Accommodation Details Do you require Hello Ireland to organise accommodation, as set out in our web site, for your student. Yes No • Courses and expected numbers. Please complete the table on the next page • Activities Selected If you plan to send groups for the general teenage programme HI006 we are offering three options for activities. You can find details of these on our web site. We would appreciate an estimate of the numbers likely to select each package, to help us in planning. The prices given in the brochure and applications form are for Package A. • Airport Transfer Required Yes No Details of flight numbers, airport and arrival time must be provided at least two weeks before course commencement. • Deposit Payment Details I will pay by: Bank Transfer Credit Card Visa Master Card Credit Card Details: Name of Card Holder Card Number / / Expiry Date: / / Card holder signature I have read the terms & conditions overleaf and agree to abide by them Signed: Date: Agent Stamp
