Form

Wild Bush Luxury - Agent Application

Company name*

Company Website URL

Company Tax Number/Company Business Number*

Please share any additional information on your business (include predicted numbers to region)*

Please clarify what type of operator you are (primarily)*

ITO

OTA

Retail Agent

Wholesaler

What is your postal address?

City

State

Postcode

Country

Contact Person Details

First name*

Last name*

Position

Email*

Phone number*

Accounts Contact Person

First name*

Last name*

Email*

Phone number*

I agree to pay in advance in accordance with Wild Bush Luxury payment terms*

Payments are to be made to Wild Bush Luxury Experience Pty Ltd on behalf of Arkaba/ Arkaba Walk/ Bamurru Plains/ The Maria Island Walk. Full pre-payment is required 60 days before arrival. For bookings made within 60 days, payment is within 48 hours. If payment is not made in full by the due date, the booking is subject to automatic cancellation.