Incas Del Peru

Reservation and Booking for Homestay

Your submission of this form is an agreement to these documents .

Please read and ensure that you understand Booking Conditions before registering.

Full Name *

E-mail *

Occupation

Birth Date *

Sex *	Male Female

Marital Status *

Phone *

Fax

Address *

Country *


Dates


Total Number of Days

Start Date *

End Date *

Number of Weeks of Spanish Course *


Type of Lodging


Comfort homestay with a Peruvian family :	$ 150/week in a private room (one person) $ 250/week in a private room (two persons)

Budget homestay with a peruvian family (shared toilet) :	$ 120/week in a room(one person) $ 200/week in a room(two persons)

Please tell us any special requirements you may have regarding your lodging


Passport Information


Number *

Place *

Date of Issue (DD/MM/YY) *

Expiry Date (DD/MM/YY) *


Additional Information


Any medical condition / history / disability / dietary requirements

Name and contact details of a person to contact in case of an emergency

About Incas del Perú. Please tell us when and how you discovered Incas del Perú?


*Prices in US Dollars