Cruise Travel Inquiry Form

Thank you for choosing

Clouse Travel

to assist you in

Turning Miles into Memories.

I am a 13 year cruise veteran & I love researching to find the best deals possible. Ocean cruises, River cruises, & hotels for cruises. Please fill out this Vacation Inquiry Form in its entirety, and I will be in contact with you within 72 hours to discuss your itinerary in detail.
Dates, Locations, & Preferences are extremely important.

More than one cabin? Please fill out a separate form.
Passports may be obtained At the Post Office
Legal Name of Adult One *

First NameLast Name
Address Of Traveler ONE*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Traveler ONE*
example@example.com
Phone Number Traveler ONE*
Traveler One D.O.B. '*

MonthDayYear
Date
Do you have a valid Passport?*

YesNoI don't know how
Will you be pregnant at time of travel?

YesNoNot Applicable
Any medical conditions that could restrict travel?*
Including food allergies, Cpaps, wheelchair assistance, etc
Legal Name of Adult Two

First NameLast Name
Address Of Traveler TWO, If different from Traveler ONE*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Traveler TWO*
example@example.com
Phone Number Traveler TWO*
Traveler Two D.O.B. *

MonthDayYear
Date
Do you have a valid Passport?*

YesNoI don't know how
Will you be pregnant at time of travel?

YesNoNot Applicable
Any medical conditions that could restrict travel?*
Including food allergies, Cpaps, wheelchair assistance, etc
Any travelers under age 18

YesNo
Full legal name, address, phone #, email and , D.O.B. for additional travelers under 18 or additional passengers *
Name & loyalty numbers for ALL passengers per preferred cruise line
What is your estimated budget for this trip (per person)? Please enter a Dollar Amount*
What port(s) do you prefer to sail out of ? *
Departure Date? *

MonthDayYear
Return Date?*

MonthDayYear
Are your requested dates flexible?*

YESNO
Do you prefer to be contacted by email, phone or text?
Cruiseline Preference

Carnival Cruise LineRoyal Caribbean Cruise LineNorwegian Cruise LineCelebrity Cruise LineVirgin VoyagesMSC Cruise LineViking River/Ocean CruiseDisney Cruise LineAzamara Cruise LinePrincess Cruise LineCunard Cruise LineOther
Preferred Cabin Type

InteriorOcean ViewCove BalconyBalconySuiteOther
Location of cabin? Check all that apply

ForwardMidAftLower decks? ( Main,Riviera, etc)Mid Decks? ( Upper, Promenade, etc)Higher Decks? ( Lido, Spa.,etc)Other
Possible Discounts

Senior CitizenMilitary/VeteranInterlineAARPOther
How did you find me?
Have you received any other travel quotes for this itinerary?*

YESNODo you agree to use my services?
Signature

Clear
Should be Empty:

Dates, Locations, & Preferences are extremely important.

Passports may be obtained At the Post Office