Vacation Form
All we need to get started!
Primary Host Adult #1 Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
What type of vacation?
Universal Orlando
Walt Disney World (Orlando)
Disney Land (California)
Aulani (Hawaii)
Disney Cruise
Disney River Cruise
Disney Adventures
Check-In Date Preference 1
-
Month
-
Day
Year
Date
Check-In Date Preference 2
-
Month
-
Day
Year
Date
How many rooms will you need?
When you think of a resort which of these fits your plans best?
Larger than Life fun at an affordable price
Classic Theming from around the world with balance of cost vs. amenities
Luxury Style
There are special discounts for certain groups. Are you any of the below?
None
Active, Retired or 100% Disabled Military
Disney Chase Visa Cardholder
DVC Member
Florida Resident (WDW)
Annual Passholder
California Resident (DL
Active Disney+ Subscription
Does your family have any special needs such as a wheelchair or a dietary/allergy restriction?
How are you getting around?
Rental Car, Own car, flying and need airport transportation
Favorite Characters, movies or items to be noted:
Transformers, Hard Rock FAN, Stitch, Star Wars, etc.
Are you celebrating a special occasion?
Birthday, Anniversary, Graduation, etc.
What's the most important thing for your family to experience?
Meet Princesses, Star Wars, Ride all the rides, Eat great food, etc.
What sounds best to you?
$1500 - $3000 (Short trip)
$3000 - $5000 (week or luxurious short trip)
$5000 - $10000 (a nice week or longer trip)
Group Trip
Something else
Do you already know where you would like to stay, if so, where?
Hard Rock Hotel, Animal Kingdom, etc.
What type of rooms will you need?
Standard Room
Preferred Room (Standard room with preferred location on resort)
Standard Room with upgraded park view or pool view (depends on resort)
Preferred Room with upgraded park or pool view (depends on resort)
1 Bedroom
2 Bedroom
3 bedroom
Villa
At Disney - what type of Disney resort will you consider?
Value $ (WDW only)
Moderate $$
Deluxe $$$
Deluxe Villa $$$$ (WDW only)
Other Hotel Accommodations
At Universal, what type of hotel will you consider?
Value $
Prime Value $$
Preferred $$$
Premier $$$$
Which type of Theme Park Tickets would you like?
1 Park Per Day
Multiple Parks Per Day (4 at WDW, 2 at Disney Land, 2 at Universal)
Park Hopper Plus (WDW- 4 parks plus 2 water parks)
Are there any other events, enhancements or tickets you would like to add on to your Vacation?
VIP Tour, Holiday Parties, etc.
If there is anything else you would like for me to know or any questions you have:
Billing Address for Primary Host Adult #1
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Adult #2 Name
First Name
Last Name
Adult #3 Name
First Name
Last Name
Children Name (first and last), Age, Birthdate
Amy Shackelford, 14, 01/22/2005
Adult Names and emails (use Disney+ accounts if applicable)
Amy Shackelford, shackelford@gmail.com
Misc.
Universal and Disney both have different vacation packages and options to choose, once you return this form, I'll offer a vacation recommendation to suit your needs. I am happy to meet with you in over the phone, via zoom or in person to go over your options. Please remember this is a tool that I have provided to you to use to help me recommend your ideal vacation, not an obligation to buy.
Submit
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Should be Empty: