Customized travel for individuals with disabilities

Accessible Italy - Tourism Services for Individual with Disabilities
Accessible Italy > Individual Travelers Reservation Form

Individual Travelers Reservation Form


Email (Mandatory)
Full Name (Mandatory)
Name of Company
Nationality
Street/PO Box (Mandatory)
City and State (Mandatory)
Home Tel. number (Mandatory)
Work number
Fax number
Web Site address
If you are interested in our standard group tours, please check here
If you are interested in our individual travel services, check here  and
fill in the below information
Total Number of Persons Traveling (including infants and children)
Number of Persons with Disabilities Traveling
Indicate type of disability: physical visual audio other
If physical: make a few steps make a few stairs confined in wheelchair
Please indicate if you use: manual wheelchair electric wheelchair scooter crutches
Equipment dimensions: Height Large Weight 
Dates
Arrival Date
 Departure Date
Cities
Cities you wish to visit
Florence
Rome
Venice
Milan
Siena
Pisa

Other
Other
Other
Other
Other
Other
Hotels
No. of nights (Total no. of nights you want to stay in Italy)
How Many Nights?
Florence
Rome
Venice
Milan
Siena
Pisa
Verona
Naples
Other
Type of accommodations Budget - Moderate - Luxury
No. of rooms (Total no. of rooms you need in Italy)
How Many Rooms
of single rooms
of double rooms
of triple rooms
 Roll-in shower
Roll-in shower
Roll-in shower
 Accessible Bath
Accessible Bath
Accessible Bath
 Able-bodied
Able-bodied
Able-bodied
Hotel Special Request
Transportation
Transfer
No. of seats
Seat Characteristics
Tie-down - Accessible - Able-bodied
Location
from -- to -- in
from -- to -- in
from -- to -- in
from -- to -- in
from -- to -- in
Transportation Other Request
Excursions
Excursions
Select your excursions
TIME --- TO ---FROM

TIME --- TO ---FROM

TIME --- TO ---FROM

TIME --- TO ---FROM

TIME --- TO ---FROM

Excursion Special Request
Rental Equipment
No. of Days Rental Equipment in
No. of Days Manual wheelchair in
Rental Special Request
Other
Other Special Requests
General Comments


Tel. from Europe: +378-941111 or +378- 0549- 941111
from US: 011-378- 0549- 941111 or 011-378- 941111

Fax from Europe: +378-941110 or +378- 0549- 941110
from US: 011-378- 0549- 941110 or 011-378- 941110
ACCESSIBLE ITALY
Via C. Manetti 34
47891 Dogana
Repubblica di San Marino
E-mail: info@accessibleitaly.com