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Inscription form
You must not fill this bulletin that once your taken decision to reserve your trip with us.

This inscription bulletin is so important for us as for you for it is the basis for a good sequence of your future travel with Puka Nina. A bulletin by person will have to be filled and sent through this inscription form, that we will receive by e-mail after validation on your part at the bottom of form. It is therefore essential for us that you filled with cares the fields that you can fill. The infos in duplication (same insurance for all the participants for example, same address) will be able to be filled on a principal bulletin but it will be necessary about it to fill a by in a manner obligatory participant.
Thank you therefore to fill it with the biggest care.
Fields with ( ) are necessary.

Form to fill carefully

Grup :
Surname :
Name :
Selected program :
Passport :
Nationality :
Date of birth :
day     month     year  
Rooming desired :
Arrival airline :
Flight number (only write the number) :
Date :
day     month     year  
Arrival time :
  hh     mm
Departure airline :
Flight number (only write the number) :
Date :
day     month     year  
Departure time :
  hh     mm
Email :
Alternative email :
Tel :
Cel :
Fax :
Address :
City & postcode :
Country of residence :
Profession :
Ensurer :
Contract number :
Ensurer address :
City & postcode :
Tel 1 :
Tel 2 :
Tel 3 :
Fax 1 :
Fax 2 :
Fax 3 :
Things we should know (eventual diseases, allergies, food preferences, etc.) :
Person to notify in case of disaster 01 :
Tel :
Email :
Person to notify in case of disaster 02 :
Tel :
Email :
Person to notify in case of disaster 03 :
Tel :
Email :
Hotel reception if mudule :
Hotel address :
     


Call & ask us...

We will respond to your question in english from our offices in Cusco, Peru
+51 84 274090.
From monday to friday De lunes a viernes (except peruvian holidays) during office hours, local time -5GTM

Lasts news...

published on 07/06/2011
Ollanta Humala President of Perú
Yesterday, June 5, 2011 was held the second round of presidential elections in Peru.   It's official now, Ollanta Humala, left-wing nationalist candidate has ... more...
published on 11/10/2010
Super promo cruise in Amazonia
Discover the Pacaya Samiria National Reserve, the most important natural reserve in Peru, one of the richest in the world in any case, in ... more...
published on 23/03/2010
A dream made reality...
Soon, on March 26th exactly, Puka Nina will receive in Lima Catherine Reyrol, inhabitant of Rungis, a Director, for whom, as she says, Peru ... more...

PUKA NINA PERU
Avenida 7 H15-5 Urbanización Larapa Grande San Jerónimo | Cusco Perú | Telefax: + 51 84 274090
Razón Social: Puka Nina Perú S.A.C. | RUC # 20527409757 | Licencia Municipal # 00762 | Licencia de turismo # 087-2010-GR Cusco- Dircetur- DT
C/O CYBERservices Luxembourg 69, Bld de la Pétrusse L-2320 LUXEMBOURG
http://www.pukanina.com/en/ | perou@pukanina.com

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