Puma Expeditions
PLATEROS 345 CUSCO-PERU - PHONE/FAX 011-051-084-252931
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Response/Registration Form
Name of the Trip
Code Trip
Departure Date
Pacha Events:
Pachatusan Inkari 98´
Pachatusan Inkari 99´
Secrets of Machupicchu 99´
Esponsor in Location/Dates
Name
Mailing Address
Zip, Postal Code
Country
Home Phone
City
State/Prov
Zip/Postal Code
Country
Business Phone
Age
Sex
Citizenship
Passport Nº
Date of Birth
I can Share a double room with
Single Supplement
Please complete the check or Credit Card Information in order to charge your deposit
Check or Money Order
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Expiration
Puma/Pacha/Condor Programs/Info. :
Comments/Questions