SPECIAL 2004 CONTESTANT AIRFARE
BY AIR TAHITI NUI
TAHITI – ISA OPT WORLD KNEEBOARD
HORUE 2004

PRINT AND FAX PLEASE, NO LATER THAN 1 JUNE 2004

AIR TAHITI NUI RESERVATIONS
Fax (689) 46 02 22 & Phone (689) 45 55 55
Email vad@airtahitinui.pf
PPTCCTN2004/APR/KS
HORUE KNEEBOARD CHAMPIONSHIP BOOKING REQUEST
DATE:
PASSENGER DATA/COUNTRY:
CONFIRMATION NUMBER TO THE CONTEST:

FIRST NAME:

LAST NAME:

TEL/FAX N°
EMAIL:

PASSPORT NUMBER:
PASSPORT EXPIRATION DATE:


ACCOMPANYING PERSON
LAST NAME:
FIRST NAME:

PASSPORT NUMBER:
PASSPORT EXPIRATION DATE:
 
ITINERARY
ORIGIN /PAPEETE/DESTINATION

DATE OF FLIGHTS

 
CLASS: N° Y or J?
IMPORTANT : Tickets have to be booked and ticketed no later than 3 weeks in advance - No fees for will-call tickets
 
PAYMENT: Credit Card or Wire Transfer
LAST NAME
FIRST NAME
CARD TYPE (visa, master..):
CREDIT CARD NUMBER:
CARD EXPIRATION DATE:
TOTAL AMOUNT:

I authorize Air Tahiti Nui to charge my credit card
SIGNATURE:

 
 
BANK WIRE/TRANSFER DETAILS
Date:
Amount:
Los Angeles BANK OF WEST San Francisco
Acct 042 000422
France BANQUE LAYDERNIER-FAVERGES Paris
Acct 10228 4609 104626 042 00
New Zealand BANK OF NEW ZEALAND Auckland
Acct 100-0100017-00
Japan BNP PARIBAS TOKYO BRANCH TOKYO
Acct 00001 00444/001/28 JPY
 
In order to hold your reservation, please send back this form to:
AIR TAHITI NUI RESERVATIONS
Fax (689) 46 02 22 and Phone (689) 45 55 55
Email vad@airtahitinui.pf
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