Travel Intake Form

Take You Away Travels (Travel Assistance Request Form)

Thank you for contacting Take You Away Travels for travel planning assistance.It is vital to input all information that is requested within this form. Quotes are normally provided within 48-72 hours, sometimes sooner if time permits. I look forward to assisting you with your travel needs. Thank you for requesting my services. -Nanassa M
Contact Info

First Name, MI Last
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email Address
This is where you will receive quotes, photos, reservation number, and any other documents pertaining to your trip.
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Is anyone traveling over the age of 55?
Destination?
Where do you want to travel?
Departure

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Return

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Departure airport of choice (Even if air is not booked please specify where you're departing from)
Do you have a valid passport?
What are we booking?

Other
Arrival airport of choice
Airline Preference
How many Adults are traveling?
How many Children are traveling
Age of children?
At time of travel
Type of lodging requested
Number of rooms
Types of rooms
(Queen, King, Double beds)
Any Special needs travelers?
Travel Insurance (Accept or Decline)
Travel insurance is highly recommended. Without insurance, you will be charged fees to cancel and/or make changes after the booking is completed.
Celebrating a special occasion?
EX: Birthday, Anniversary, Graduation
Total Budget (Per Person)
Trip Deposit info
Please be advised that a minimum deposit or full payment will be required for your booking. Amounts depend on the type of trip request. Do you agree with the statements? (Yes or No)
If i have missed anything important please list here:
Add any additional here questions, concerns, etc,,.
Signature
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Take You Away Travels (Travel Assistance Request Form)