Please complete form and email to

Name of tour:

Date of tour:

Your name (exactly as it appears on your passport): 

Passport no:                                                       Passport expiry date:

Country where your passport was issued:

Date of Birth:                                                      Nationality:

Your name (as you wish it to appear on your certificate):


Contact phone number:                                                   

Email address:

Next of kin name:

Next of kin phone number:

Next of kin address:

Do you have any previous experience of holistic therapies, personal development or spiritual philosophies? (This is to assess the experience level of the group.) 

Would you be happy to continue with the tour as a member of a small group, ie. if the minimum number of participants is not achieved? YES/NO  

I do/do not require single room accommodation at an additonal charge of £350.

I enclose a copy of my Travel Insurance certificate (please tick):

I have paid the Deposit/Full Price of the tour by Paypal payment on the Alkhemi®Travel website. (Please circle.)

I have read, understood and agreed to the Terms and Conditions as they appear on the Alkhemi®Travel website (please tick):