Name of group/class*:

Name/first name of purchaser*:

Address*

Postal code/city*:

Telephone, office:

Telephone, private:

E-mail address*:

Mobile phone (confirmation by text message):

Holiday address:

Mode of payment:

With credit card or invoice:

Invoice address (if different from purchaser's address):

Ticket collection on (date):

Number of seats:

Timetable(only enter one train/ship/bus per line)

Date	Time	from	to

Category:

With half-fare travel card:

Without half-fare travel card:

With Annual Rail Season Ticket:

Children aged 6-16 years:

With half-fare travel card:

Adults without half-fare travel card:

With Annual Rail Season Ticket:

Young people aged 16-25 years:

Children aged 6-16 years:

Remarks: