Costa Rica Travel Response Form

Fill out this form to receive information and brochures about your specific travel interests in Costa Rica.

Name Age
Street address
Address (cont.)
Zip/Postal code
Work Phone
Home Phone

Other Travelers

Name Age
Name Age
Name Age

When do you expect to travel ?

Where will you be departing from ?

What is your approximate budget (without airfare) ?

What type of accommodations do you like ?
Moderate Deluxe Best Available

What is your underwater experience ?
Scuba Diver Non-Scuba Diver Want to Learn

Which hotels sounds appealing ?............. (Use Ctrl key for multiple selections)

What are your areas of interest ? ............. (Use Ctrl key for multiple selections)

Which tours sound interesting ?............. (Use Ctrl key for multiple selections)

What type of car would you want ?

Where did you hear about us ?

Please enter any Questions or Comments:

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