1. What places do you wish to visit and on what dates?

	Punta del Este	From:
		To:

	Montevideo	From:
		To:

	La Paloma / La Pedrera / Punta del Diablo	From:
		To:

	Piriápolis	From:
	Argentino Hotel de Pirápolis	To:

	Colonia	From:
		To:

	Ranches	From:
		To:

	Termas	From:
		To:

	Fray Bentos / Mercedes / Tacuarembó	From:
		To:

2. Do you travel alone or accompanied?

How many people travel with you?
How many of these people are under 12 years old?
How old are these children?

3. How will you travel from your country and within the Uruguayan territory ?

I want transportation from the airport to the hotel:
I wish to rent a car for my stay:
I wish to rent a car for only a few days:	Total of days

4. Personal Information:

Name:
E-MAIL *
Country:
City:
Do you wish to receive tourist information periodically ?	Yes No

If you wish to include additional information, please do so here. Tell us if you prefer double bed or twins beds.