Melanated Madam Travel

Melanated Madam Travel

Travel Inquiry Form
Thank you for choosing Melanated Madam Travel as your travel advisory team! As any other business, I pride myself on honesty, integrity, transparency and confidentiality. I will do my best to ensure you have the most stress-free experience possible.

Please complete the travel form below to register for your next trip or getaway.

Step One: Complete Travel Inquiry Form.

Step Two: Vacation Quotes- we ask that you allow 3-5 days for a response. This time will allow us to find every deal possible to get you what you require and deserve. These will be emailed to the address provided from the form. If you have more than 4 travelers, please let us know so that the form can be adjusted.

Step Three: Secure your dream vacation! To secure the quoteed price, most vendors require a deposit payment within 48 hours. Please be "Deposit Ready" at the time of your price quote. Once prices are confirmed and you are ready to proceed with your purchase, a Credit Authorization Form will be sent requesting authorization to process payments.
Travel Request Form

Please answer each question fully.
First Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Second Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Third Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Fourth Traveler Information

First NameLast Name
Date of Birth
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Fifth Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sixth Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Seventh Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Eighth Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ninth Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tenth Traveler Information

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Travel Budget per Person
Destination of Interest
Date of Departure

MonthDayYear
Date
Date of Return

MonthDayYear
Date
Departure Airport
Return Airport
Departure Time Preference
Type of Trip
Thank you for your interest!

The information provided will assist in getting your quote prepared, and ensure that I provide the best experience to you.

Once submitted, we require 3-5 business days to prepare your quotes. You'll receive three separate quotes, so that you have options.

Administrative fees are as follows: Individual trips are $10, group trips of 2-5 are $25 groups of 5 or more are $45. This fee is for processing and administrative purposes. There are no exceptions. This payment is due before any quote can be started.

To secure the quoted price, most vendors require a deposit, and sometimes full payment at the time of the price quote. Being "Deposit Ready" is essential. After the quote has been agreed upon, all payment information will be required to process payments to the vendor(s).

GROUP TRAVELERS- Everyone must pay the deposit together. Deposits cannot be split in multiple payments.

Once prices are confirmed and you are ready to proceed with one of the quotes, a Credit Authoruzation Form will be emailed requesting to process payments on your behalf. Requests will be provided for each payment given.

Cancellation Policy of Trips:

If your trip needs to be cancelled for any reason, there will be an invoice sent to you from Melanated Madam Travel via Square. The fee to cancel is $50 per booking for 1-5 people, $75 for 5 or more.

Thank you for choosing Melanated Madam Travel! We look forward to working with you!
Do you agree with the terms described above?

Yes, I agree with the terms.No, I disagree with the terms.
Signature

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Associated Administrative Fees

Single Traveler Adminitrative FeeEnter description

$10.00

2-5 Travelers Administrative Fee

$25.00

6+ Travelers Administrative Fee

$45.00

Total

$0.00

Credit Card

Should be Empty:

Melanated Madam Travel

Travel Request Form

Credit Card