Order Form

General Info

ScreenName:	*
Email:	*
Telephone:	- - *
Payment For:	Select a Category Merchandise Membership Subscriptions Galapagos Week 1 - Dec 01 - 08 2014 Galapagos Week 2 - Dec 08 - 15 2014 Galapagos Week 3 - New Year's Eve Dec 29 2014 - Jan 06 2014 Best of Fiji Week 1 - 7 days Beqa Lagoon Mar 03 - 10 2015 Best of Fiji Week 2 - 10 days D/V Siren Liveaboard Mar 10 - 20 2015 Best of Fiji Week 1 - 11 days Beqa Lagoon Mar 03 - 14 2015 Best of Fiji Week 2 - 13 days Beqa Lagoon AND D/V Siren Mar 07 - 20 2015 Grenada Week One - Apr 18 - 25 2015 Grenada Week Two - Apr 25 - May 02 2015 Dominica Week One - May 23 - 30 2015 Dominica Week Two - May 30 - Jun 06 2015 Best of Florida July 03 - 11 2015 Cayman Brac July 11 - 18 2015 Roatan Week 1 Aug 01 - 08 2015 Roatan Week 2 Aug 08 - 15 2015 Bonaire Sept 05 - 11 2015 Wakatobi Oct 12 - 23 2015 Belize Thanksgiving Liveaboard Nov 21 - 28 2015 Other Group Travel Individual Travel *

How You Will Pay

eCheck (free)
Visa/Mastercard (adds 3% non-cash convenience fee)

Please enter only what you are paying for on this transaction. You will need to enter the cost and then click the 'calculate' button.

Trip Items

Full Trip Base Cost	$
Trip Deposit	$
Progress Payment	$
Nitrox	$
Rent-A-Buddy	$
Extra Days	$

Trip Options/Merchandise (Please give details in the space provided)

Other:	$
Other:	$
Other:	$

Shipping

Please fill out this section if you are purchasing merchandise.
Shipping Cost:	$
Insurance:	$

Discounts/Referrals

If you were given a discount or referral code please enter it here.
Discount:
Referral:

Payment Due

3% Convenience fee	$
TOTAL	$

The box below can be used to add any comments required to complete your order. You can elaborate on what you want to do or give us special instructions for example, how many extra days you want or how many nitrox tanks you need if pricing is not a weekly package price. If booking a trip you can cut and paste the booking template here and use this as an order form for the entire trip. This will help our accountant know exactly what you want and what you are paying for. Please be as specific as you can.

Comments:


Clicking the 'Pay Now' button below will take you to our payment gateway where you can complete your transaction. If you find an error in the payment gateway information just return to this page, fix the error, click the 'Calculate' button again and then press 'Pay Now' again. (You may or may not be able to use your back button to return depending on your browser.)