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	Number of Travelers	Adults
		Children under 16 years

	Where Would You Like	Mt. Kilimanjaro climb only
	to Go?	Mt. Kilimanjaro
		Serengeti
	(check all that apply)	Zanzibar & beaches
		Lake Manyara
		Olduvai Gorge Archeological Site
		Ngorongoro Crater
		Selous Game Reserve & Southern Circuit Safari

	What Would You Like to Do?	Mt. Kilimanjaro Climb (allow at least 5 days for climb)
	What Would You Like to Do?	Serengeti Animal Safari
		Serengeti Hot Air Balloon Safari
	(check all that apply)	Walking Safari
		Beaches & Watersports
		Scuba Diving
		Visit Masaai & other native cultures
		Cultural Tour
		Archeological Tour
		Relax & Have a Good Time

	When Do You Want to
	Travel?

	For How Long	14 days
		9 days
		7 days
		5 days
		other

	Any Special Needs or
	Considerations?

	Comments or Questions We Can Answer for You
	Comments or Questions We Can Answer for You

	How Did You Hear	Surfing the Web
	About Us?	Travel Magazine
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