header logo and photo banner
left spacing left spacing

Information Request

Feel free to contact us by any method convenient for you, including this request form. As always, we will not share your information with anybody.

Fill out the address change if you would like to update your address or other information we already have on file. Or fill out the Travel Guide request if you simply want us to mail you our latest brochure.

*First Name
*Last Name
Address
City
State or Province
Zip or Postal Code
Country
Phone
*Email
*Retype Email
Where do you want to travel?
(check all that apply)		 Antarctica, So Georgia & Falklands
South Georgia & Falklands
Svalbard (Norwegian Arctic)
Costa Rica
Panama
Belize
Galapagos
Trinidad and Tobago
Argentina
Brazil
Chile 		Silver Banks
Monterey, California (daytrip)
Alaska
Botswana
Kenya
Tanzania
Ethiopia
Madagascar
New Zealand
India
Bhutan
Other (comment below)
What are your interests?
(check all that apply)		 General
Biology
Birding
Botany
Conservation
Entomology 		Hiking
Photography
Non-birding
Wildlife Watching
Other
How did you hear about us? Audubon magazine
Outdoor Photographer magazine
Other printed ad
Flier
Our brochure
Recommendation from:  
Web search (ex: Google)
Web link from another website
Other:  
Want to receive our quarterly email newsletter? yes   (it's easy to unsubscribe)
no
Are you a nonsmoker (we take only nonsmokers)? yes
no
Are you interested in wildlife and being out in the field all day? yes
no
*Traveled with us before? yes
no
*How should we contact you? Telephone
Email
Mail (Post)
Want us to send you a specific itinery? See our current trip list
Have any comments and questions?
*Required information

Return to top

 

All material © Cheesemans' Ecology Safaris.
All photos © Doug or Ted Cheeseman, unless otherwise credited.
| Home | Current Trips | Site Map | Contact Us | About Us |