Island Hopper Samoa Reservation request form

Dear visitor,

Please complete this easy form with your details and request for your holiday. We will do the utmost to reply within 2 business days.

Step 1: Your Trip

Number of persons:

Number of adults:

Number of children under 12:

Number of children under 2:

Your arrival date:

Your departure date:

Arrives from:

Airline:

Flight number:

Step 2: Accommodation, tours, rental selection

Please select below up to 5 preferred choices for your holiday. You can select hotels, motels, rental car companies, tour companies etc. Below each selection please type your request in as much detail as you can in order for us to better meet your requirements.

Please select area:

Please select supplier:

Request:

Please select area:

Please select supplier:

Request:

Please select area:

Please select supplier:

Request:

Please select area:

Please select supplier:

Request:

Please select area:

Please select supplier:

Request:

Step 3: Personal Information

We would like to assure you that the information we asked for in this form is strictly for use in booking your travel. It will not be used for unsolicited mailings or distributed to any other company.

Your name:

E-Mail:

Address:

Remarks:

Thank you for your request!

Island Hopper Samoa

PO Box 2271

Apia

Upolu Island, Samoa

Main phone: +685 26 940 Main fax: +685 26 941

E-Mail: samoa.sales@islandhopper.com.ws