Your Details
Title:
--Please Select--
Mr
Mrs
Miss
Forename:
Surname:
Telephone number:
Mobile Number:
E-mail Address:
Fax:
Nationality:
NRC/Passport No:
Reserved By:
Arrival and Departure Details
Arrival Time:
Hour
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Minute
00
05
10
15
20
25
30
35
40
45
50
55
Arrival Date:
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
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2007
2008
2009
Departure Date:
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
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2007
2008
2009
Arriving By:
Air
Car
Bus
Flight No:
Airline:
Number In Party
Number of Adults:
[Select]
1 adult
2 adults
3 adults
4 adults
5 adults
6 adults
7 adults
8 adults
Number of Children (12 and Under):
[Select]
0
1
2
3
4
5
6
7
ROOM REQUIREMENTS
Room Required:
Single
Double
Twin
Chalet Type:
Chalet with living room
Private Chalet
Main house: private/shared (no aircon)
Acceptance of Terms & Conditions
I confirm that the above details are correct
Chimfule Lodge, P.O Box 101, Mfuwe, Zambia Tel: +260 6245129 Email: chimfulelodge@IwayaAfrica.com