Wanderlust by Notiq™ Kenya 2020 Booking Form

Payment Options

How would you prefer to pay for your trip?*

Lump Sum Payment (Full payment at the time of booking)
Non-Refundable Deposit + Basic Payment Plan (no interest) Note: With this option your travel has to be paid in full prior to departure.

Lump Sum Payment

After you submit your deposit, you will be contacted directly to submit your remaining balance.

Payment Plan Information

Would you like your monthly payment to be withdrawn on the 1st or 15th of each month?*

1st day of each month
15th day of each month

Will you and your roommate be submitting separate payments or will you be on one payment plan?*

Yes, separate payments (each traveler submits their own payment)
No, group payment (only one form of payment)

Please click "Submit" button below and we will contact you directly to complete your Uplift™ application. Note: Notiq Agency reduced deposit offers and promotions not available for Uplift™ financing option.

Any additional questions or concerns

Secure Payment Information

Note: This card will not be used for any additional payments. You will be contacted directly to complete a credit card authorization form for your remaining balance.

Total Deposit Amount Due

$0.00

Deposit Payment is Non-Refundable

Payment Method*

Credit/Debit Card
Paypal (Submit form and you will be redirected to PayPal for payment)

Billing Address*

Same as previous

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Final Booking Consent and Booking Terms & Conditions Agreement

Booking Terms and Conditions*

I have read and agree to the booking terms and conditions

Final Booking Consent*

I confirm that I am ready to submit my deposit today and if I have roommates, all of my roommates are also prepared to submit their deposit today. I understand that pricing cannot be guaranteed until the time of booking and pricing can only be held today so if I (or any of my roommates) do not return the credit card authorization forms today by 7:00 PM EST, there is a $35.00 per person rebooking fee. I agree to these terms and I am ready to proceed with booking today.

Next Steps: After we receive the booking form from you and all of your roommates (if any), we will proceed with your booking and you will receive your final itinerary/confirmation and credit card authorization form. You can complete your credit card authorization form electronically on your phone, tablet, or desktop. You must return it today by 7:00 PM EST to avoid the rebooking fee of $35.00 per person.

I have read and agree to the final booking consent

Signature*