Blue star ferries Reservation form.

ONE WAY TRIP DATA

Date of Departure

/ /

Route

Accommodation Category

Vehicles Category

Registration Nr (plate)

Vehicles Category

Registration Nr (plate)

RETURN TRIP DATA

Date of Departure

/ /

Route

Accommodation Category

Vehicles Category

Registration Nr (plate)

Vehicles Category

Registration Nr (plate)

PASSENGERS DATA

Passenger	sex	name	surname	age	nationality	passport number
No 1
No 2
No 3
No 4
No 5
No 6
No 7
No 8

*The following fields are required :

*Name:

Fax:

*E-mail:

Please make sure it is correct.

*Telephone:

Mobile Phone:

Address:

How did you find us
in Internet?

Comments

PAYMENT DATA

I authorize Paleologos S.A. Shipping and Travel Agency to charge my credit card :

Credit Card

Name on Credit Card

Card Issue Date

Card Expiration Date

Credit Card Number

ATTENTION VISA AND MASTERCARD CARD OWNERS!
According to the VISA and MasterCard International Organisations, the three (3) digits verification number following your card's number at the back of your card, by the signature (see example), is ABSOLUTELY NECESSARY
in order to complete a mail order.
Please insert your verification number in the box bellow.

Credit Card Verification Number :

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