Travel Client Intake Form

1
Main Traveler’s Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Please enter a valid phone number.
3
Email* This field is required.Addres
example@example.com
4
Physical Address* This field is required.
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
Where would you like to travel?* This field is required.Airport code is helpful if you know it.
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Ok
Ok
6
What are your travel dates?* This field is required.Arrival and departure dates?
7
Are your dates flexible?* This field is required.Please choose only one option.
YESNO
8
Do you require flights?* This field is required.Please choose only one option.
YESNO
9
What is your departure city?Airport code of departure city is REQUIRED if flight is needed.
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Ok
Ok
10
Preferred Departure flight time?i.e. Morning, Late Morning, Afternoon, Evening
11
Preferred return flight time?i.e. Morning, Late Morning, Afternoon, Evening
12
How many adult travelers? 1) Please include each adult's Legal Name 2) Please include each adult's Birthdate* This field is required.Legal name is the name on the driver's license or passport. Please type N/A in the fields if needed to move forward.
13
IMPORTANT: For Caribbean and International trip, please include your Name exactly as spelled on your Passport here: blanks . Also include your Passport Number here: blank and your Passport Expiration Date here . If you do not have this info please include N/A in all 3 fields and you agree to add this information to your reservation at a later time. Please ensure your legal name in the previous question is the name on your passport (not driver's license, if different) for all international and caribbean trips.
14
How many Children Travelers? 1) Please include each child's Legal Name 2) Please include each child's ageLegal name and age is required
15
What activities do you want to enjoy on this trip?Please select all that apply.
Sightseeing/history
Culture/arts
Beach/sun
Active/sports
Wine/culinary
Shopping
Spa
Other
16
If you selected “other”on the last question, please describe the activities that you were looking to enjoy on this trip?Please explain the amenities you are wanting (i.e. Private got it tour, luxury, experience, etc. if applicable)
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Ok
Ok
17
Room view, desiredPlease select all that apply
Oceanfront
Ocean view
Partial ocean view
Other available view
Least expensive
18
When it comes to travel, what is most important to you?Please choose only one option.
Memorable experiences
Strict budget
Somewhere in between
19
What is your vacation/travel budget?Please select an option(s) that is realistic for your total budget
< $1,000
$1,000-$2,500
$2,500-$4,500
$4,500-$7,500
>$7,500
20
Do you need a rental car? If so, what type?Please choose all that apply.
No
Economy
Compact
Intermediate
Standard
SUV or Luxury
21
Do you need a transfer to and from the airport?
22
What is your Frequent Flyer Number? 1)Please include each adult's Name 2) Please include each adult's frequent flyer number (FFN)* This field is required.If you do not have this info please include N/A in the fields to move forward and you agree to add this information to your reservation at a later time. Name is 1st box. FFN is 2nd box.
23
What is your TSA Number? 1)Please include each adult's Name 2) Please include each adult'sTSA number* This field is required.If you do not have this info please include N/A in the fields to move forward and you agree to add this information to your reservation at a later time. Name is 1st box. TSAN is 2nd box.
24
Important - are you prepared to pay for or provide required deposit to secure trip immediately after desired itinerary, and budget is obtained? Read below. Pricing is not final until travel is booked. Delays in making a final decision may result in fluctuating pricing as travel rates change from minute to minute. Time spent on additional searches and updating pricing due to delays in decision will result in an additional $50 research/service fee for each search. Additionally, if you request changes once your trip is finalized and booked, it will result in an automatic $50-$100 service fee depending on time spent. Are you prepared to pay for or provide deposits after desired itinerary and budget is obtained to avoid these scenarios?
YESNO
25
Important - is all the information in the intake, form fairly accurate, most importantly, your budget and your ability to move forward once the desired itinerary and budget is obtained?One search will be conducted with a minimum of three (3) options provided. Any additional searches after 3 will require an upfront $50 service/research fee.
YESNO
26
Do you understand that a $50 service fee will be collected upfront to begin working together on your trip. Read below:* This field is required.Should you decide to move forward with your trip the $50 service/research fee will be applied to your upcoming trip. if you decide not to move forward, then the $50 research fee is non-refundable.
YESNO
27
Signature* This field is required.I acknowledge, confirm and agree to the $50 service and understand all terms & conditions above.
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