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NAME AS PER-PASSPORT
CONTACT DETAILS
Address *
Address
NEXT OF KIN (Not Travelling) - Emergency Contact Person
Name *
Name
PASSPORT DETAILS (VISA DETAILS-If Not New Zealand Passport)
If other the New Zealand, please enter details for Re-Entry Permit
VISA/COUNTRY PERMITS (If Applicable)
AIRLINE MEMBERSHIP/S
Checkbox *
SPECIAL REQUIREMENTS
ACCOMMODATION
Copy of Passport (and Visa if required) to be sent to info@manasetravel.co.nz *