Katie Salyers
A proud affiliate of Academy Travel
Vacation Request Form
This form can be used for all vacation requests (Adventures By Disney, Disney Cruise Line, Disneyland, Walt Disney World, Universal Studios Orlando/Hollywood, SeaWorld, and more! )
Name
Email
example@example.com
Phone Number
Travel Dates (Check In)
/
Month
/
Day
Year
Date
Travel Dates (Check Out)
/
Month
/
Day
Year
Date
Number of Adults (18+)
Names of Adults
Number of Children
Names & Ages of Children at Time of Travel
Resort Type
Value $ - $$ (Average $150/night)
Moderate $$ - $$$ (Average $275/night)
Deluxe $$$ - $$$$ (Average $500/night)
Other
Vacation Destination (select all that apply)
Walt Disney World (Orlando, FL)
Disneyland (Anaheim, CA)
Disney Cruise Line
Adventures by Disney/ National Geographic Expeditions
Aulani (Hawaii)
Universal Studios (Orlando, FL)
Universal Studios (Hollywood, CA)
Sea World/Discovery Cove
Other
Resort / Ship Preference
Park Tickets (# of Days)
Ticket Type
One Park Per Day
Multiple Parks same day
Water Park & Sports option (Disney)
Other
Will you need a rental car?
Yes
No
Undecided
Please let me know if you have any discounts that may apply:
Florida Resident
California Resident
Disney Rewards Visa
Disney+ subscriber
Annual Passholder
Military
Other
Will you be celebrating any special occasions?
Special Needs / Requests
Is there anything else you would like to share?
How would you like me to contact you?
Email
Phone call
Text Message
Other
Submit
Should be Empty: