Customer Intake Form- SLWT

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Full Name
First Name
Last Name
2
Email
jordan@sololadieswilltravel.com
3
Phone Number
Please enter a valid phone number.
4
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Travel BudgetWhat is your estimated travel budget in USD?
6
Do you plan to purchase Travel Insurance?If you select "No" you will need to sign a travel protection waiver form.
YESNO
7
Number of Adult TravelersHow many 18+ travelers are in your party?
8
Number of Children TravelersHow many children 17 and younger at the time of travel are in your party?
9
Estimated Travel DatesPlease enter exact dates if known. If not please add the month or season you'd like to travel in.
10
Are the travel dates you provided flexible?
YESNO
11
Destinations of InterestPlease write down all the destinations you are interested in traveling too. This will help with planning your itinerary.
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Ok
12
What Services Will You Need For Your Trip?
Airfare
Hotel/ Resort Stay
Rental Car
Cruise Ship
Packaged Tour
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Preferred Departure CityPlease select the airports you prefer to depart from. We will do our best to accommodate.
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Airline Rewards ProgramsPlease enter any airline names and your reward information into the box below. Example: American Airlines / ABCD1234 (only an example)
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Ok
15
Seat PreferencePlease select if your preferred class of travel, and location of the seat. We will do our best to accommodate your preferences
Economy
Premium Economy
Business
First Class
Aisle Seat
Middle Seat
Window Seat
At Bulkhead
At Wing
Forward
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Preferred Cruising Company & Program IDPlease enter any preferred cruising companies and your loyalty program id numbers.
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Ok
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Cruise Itinerary/ DestinationsPlease provide locations you'd like to take a cruise
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Ok
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Preference On Cruise Length
Less Than 5 Days
5-7 Days
8-16 days
17 + Days
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PreCruise Nights At Destination?Do you want to arrive a day or more prior to your cruise beginning?
YESNO
20
Post Cruise Nights At DestinationDo you want to stay a day or more after the cruise ends at end destination?
YESNO
21
Do You Want To Include A Beverage Plan In Your Quote?Do you want an add on beverage plan to be added to your quote?
YESNO
22
If Requesting A Beverage Plan, What Types Of Beverages Would You Like Included?Examples could be alcohol (to a certain dollar amount), premium teas and soft drinks.
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Ok
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Cruise Cabin PreferencesWhat is your cabin preference?
Inside
Obstructed View
Non Obstructed View
Ocean View
Balcony
Suite
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Number of NightsHow many nights would you like to stay?
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Number of RoomsHow many rooms will you need per night?
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Hotel Chain Preferences/ Loyalty Point InformationPlease enter your preferred hotel chains and loyalty points information. Example: Hilton / ABCD1234
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Ok
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Preferred Room TypePreferred room type. We will do our best to accommodate your requests.
Standard Room
Garden View
Ocean View
No Preference
Smoking
Non Smoking
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Resort FeaturesPlease select all features you would like to have included in your quote.
All Inclusive
Adults Only
Family Friendly
Suite/Jr Suites
Near Air/Cruise Port
On The Beach
Near City Center
Kids Club
Activities On-Site
29
Preferred Car Rental CompanyPlease enter your preferred car rental company and loyal points if applicable.
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Preferred Car SizePlease select your preferred car size. Select all that apply.
Compact
Mid Size
Full Size
Luxury
Other
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Additional Comments or Add OnsAny additional comments or add ons you'd like with your rental
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Countries of InterestList countries you would like to see on your packaged tour
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Ok
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Escorted or Independent?
EscortedIndependent
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Activity LevelMinimal = basic walking nothing too strenuous Moderate = Walking on diverse terrain or uneven surfaces. Distance walking. Active= A lot of walking or moderate exercise during activities. Very Active = Adventure travel, hiking, etc.
Minimal
Moderate
Active
Very Active
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