Thank you for choosing Tasmania Sleepervans for all your vehicle requirements. Our friendly and efficient team will confirm your vehicle rental booking within 24 hours. Please do not hesitate to Contact Us if you have any further questions. Once you have completed the form please print and fax to +61 3 6265 1573 or send by mail.

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Your name Your e-mail   Email addresses must be included and correct to receive a response   Quotation Number Q- (if applicable)   Address City Address2 Country State Zip Phone Fax Driver's licence No Country licence issue Date licence issue Expiry date Date of birth

Vehicle Tick Vehicle Type sleepervan 2/3 hitop sleepervan

bond waiver insurance Yes No AU$20 per day (maximum charge of AU$1000) Please note that additional insurance is completely optional and can be decided upon collection of your vehicle.

optional accessories Colour TV $50 Side Awning $25 Booster Seat $25   Child Seat $25 Rear Awning $50 Outdoor Table $15   High Chair $25 Both Awnings $65 1 2 3 4 5 6 Outdoor chair $10 ea

Travel Itinerary

Start Location Hobart Launceston Devonport Finish Location Hobart Launceston Devonport Pick up Time 8:00am 8:30am 9:00am 9:30am 10:00am 10:30am 11:00am 11:30am 12:00pm 12:30pm 1:00pm 1:30pm 2:00pm 2:30pm 3:00pm 3:30pm 4:00pm 4:30pm 5:00pm Drop off Time 8:00am 8:30am 9:00am 9:30am 10:00am 10:30am 11:00am 11:30am 12:00pm 12:30pm 1:00pm 1:30pm 2:00pm 2:30pm 3:00pm 3:30pm 4:00pm 4:30pm 5:00pm Arrival Flight# Departure Flight#

Please give us an indication in the box below where you will be travelling:

for example: e.g Around the Hobart area e.g Touring all of Tasmania and returning to Hobart

No of Adults 01 02 03 04 05 06 07 08 09 10 No of Children 01 02 03 04 05 06 07 08 09 10

Start Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Jan (1) Feb (2) Mar (3) Apr (4) May (5) Jun (6) Jul (7) Aug (8) Sep (9) Oct (10) Nov (11) Dec (12) Year 2010 2011 2012 2013 2014 2015 Finish Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Jan (1) Feb (2) Mar (3) Apr (4) May (5) Jun (6) Jul (7) Aug (8) Sep (9) Oct (10) Nov (11) Dec (12) Year 2010 2011 2012 2013 2014 2015

Comments, Enquiries and Special Requests

Credit card details are required to confirm bookings

Name On Card

Credit Card Type Visa Mastercard

Credit Card Number

Expiry Month / Year Jan (1) Feb (2) Mar (3) Apr (4) May (5) Jun (6) Jul (7) Aug (8) Sep (9) Oct (10) Nov (11) Dec (12) / 2008 2009 2010 2011 2012 2013 2014 2015

CVV2

What is a CVV2 code? The CVV2 is a 3 or 4 digit code embossed or imprinted on the reverse side of Visa or MasterCard

I have read and understood Tasmania Sleepervans Terms & Conditions