Cruise Intake Form
I can't wait to hear about your cruise!
Email Address
*
example@example.com
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Where would you like to sail to?
*
Alaska
Asia
Australia/New Zealand
Bermuda
Canada/New England
Caribbean
Europe
Hawaii
Mexico
South America
South Pacific
The Bahamas
Transatlantic
Transpacific
Other
Do you have particular ports you'd like to visit? If so, list here.
*
Please specify your preferred departure port.
*
You may list multiple if this option is flexible.
Would you like airfare included in your proposal? (If applicable)
*
Yes
No
Maybe
If you would like flights, what is your preferred departure airport?
Please provide your trip dates or date range.
*
Are your dates flexible?
*
Yes
No
Maybe
How long would you like to go? Check all that apply.
*
Weekend Getaway
3-5 Days
6-8 Days
9-12 days
12+ Days
Other
Do you have a preferred cruise line? If so, check all that apply.
*
Carnival
Celebrity
Disney
Hurtigruten
Princess
Royal Caribbean
Viking Cruises
Other
Do you participate in any loyalty programs? If so, list which ones here along with your loyalty number.
Does anyone in your cabin apply for the following?
Age 55+
US and Canadian Law Enforcement
Fire Department/EMT
US Military or Canadian Forces
Other
What state do you live in?
*
How many staterooms do you need?
*
1
2
3
4
5+
How many guests in stateroom 1?
*
1
2
3
4
Ages of guests in stateroom 1?
*
Provide birthdays (M/D/Y) if possible.
Stateroom 1 category preference?
*
Inside Cabin
Interior View Cabin (if available)
Ocean View Cabin
Balcony View Cabin
Extended Balcony Cabin (if available)
Suite Balcony Cabin
How many guests in stateroom 2?
1
2
3
4
Ages of guests in stateroom 2?
Provide birthdays (M/D/Y) if possible.
Stateroom 2 category preference?
Inside Cabin
Interior View Cabin (if available)
Ocean View Cabin
Balcony View Cabin
Extended Balcony Cabin (if available)
Suite Balcony Cabin
How many guests in stateroom 3?
1
2
3
4
Ages of guests in stateroom 3?
Provide birthdays (M/D/Y) if possible.
Stateroom 3 category preference?
Inside Cabin
Interior View Cabin (if available)
Ocean View Cabin
Balcony View Cabin
Extended Balcony Cabin (if available)
Suite Balcony Cabin
How many guests in stateroom 4?
1
2
3
4
Ages of guests in stateroom 4?
Provide birthdays (M/D/Y) if possible.
Stateroom 4 category preference?
Inside Cabin
Interior View Cabin (if available)
Ocean View Cabin
Balcony View Cabin
Extended Balcony Cabin (if available)
Suite Balcony Cabin
What is your preferred dining time?
*
Early
Late
Anytime
No Preference
What activities are you interested in?
*
Beach
Ocean/Boats
Food/Wine
Sports/Active
Bus Tour
Wildlife
Culture/History
Family Friendly
Gambling
Golf
Other
Would you like me to include excursions?
*
Yes
No
Other
Please list any upgrades you would like. For example, beverage package, specialty dining, etc.
*
Is your trip celebrating a special occassion?
Honeymoon
Anniversary
Birthday
Other
Are you able to fly a day or two prior to embarkation?
*
What are you most looking forward to about your trip?
*
What else would you like me to know? Anything that you must see or do?
*
Would you be ready to make the deposit for your vacation if I found a package that matched what you've listed above?
*
Yes
We're just exploring our options
No
What budget range would you like to stick to for this vacation?
*
Less than $2,000
$2,000 - $3,000
$3,000 - $4,000
$4,000 - $5,000
$5,000 - $6,000
$6,000 - $7,000
$7,000 - $8,000
$8,000 - $9,000
$9,000 - $10,000
$10,000+
Other
Submit
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