Please complete and return to Michael Sharpe – sharpieboy456@gmail.com

Please copy and paste the below text into an email to the above address with the details below completed.

 Traveller 1 (Name)

Traveller 2 (Name)

Contact Telephone Number

Flights in: Airline Name:

Flight Number

Departing Date

 Departing Time

Flights Out: Airline Name

Flight Number

Departing Date

Departing Time

Accommodation: Christchurch

Hotel Name 

Hotel Address

Accommodation: Dunedin

Hotel Name

Hotel Address

Date $750.00 paid (fee is per person)

Medical Student Y/N