Your First and Last Name:       

E-mail address: mandatory for reply  

Mailing address:                      

City:                                     

State                                    

Zip Code                                

Country                                  

Phone                                    

Fax number                            

Date trip begins (Mo Day)         

Date trip ends  (Mo Day)          

Gateway City:  (Cancun, Nassau,  Mexico City, Toronto, Montreal, Vancouver,  

Freeport, Montego Bay, Cayman. Merida or Santo Domingo)

First choice of Hotel              

Second choice of Hotel         

Third choice of Hotel             

How many persons in your group?

Number of Adults                 

Ages of children                  

Number of hotel rooms         

Would you like to use a credit card? (no credit cards when traveling via Cancun.)

Name on card                    

Type card                          

Number on card                

Expiration date on card      

Names of those in your group (give age of children)

First persons full name       

Second persons name       

Third persons name           

Fourth persons name         

If more than 4 persons in your group use box below to add names and ages of children.

Tell us anything else you can about your trip plan

Cuba Travel US will do our best to confirm your trip within 2 working days. NOTE: high season can take longer, particularly on hotels....especially outside of Havana

thank you