Customer Information Form
DATE COMPLETED
/
Month
/
Day
Year
Date
Client Name
Format: (000) 000-0000.
Phone
Format: (000) 000-0000.
Email Address
Vacation Budget:
Insurance
Yes
No (If no, obtain signed waiver)
Number of Adults
Number of Children and Ages
Dates of Travel:
/
Month
/
Day
Year
Date
Dates of Travel: Flexible:
Ye s
No
Destinations of Interest
Air Travel
Departure City
Airline Preference (Frequent Flyer Programs)
Seat Preference
Economy
Extra Leg Room/Premium
Business Class
First Class
Aisle
Middle
Window
Bulkhead
Forward
Wing
Cruise Vacation
Cruise Preferences (Frequent Cruiser Programs)
Cruise Itinerary:
Cruise Length
Pre and Post Cruise Nights:
Yes
No
Cabin Class
Beverage Plan:
Yes
No
Beverage Plan Type
Hotel and Resort Vacation
Hotel Preferences (Frequent Guest Programs)
Hotel Preferences (Frequent Guest Programs)
# of Rooms/Arrangement
# of Rooms/Arrangement
Features
Standard Room
Garden View
Ocean View/Front
Other:
All Inclusive
Adults Only
Family Friendly
Concierge Level:
Features
Suite/Jr Suite
On the Beach
Near City Center
Kids Club
Near Air/Cruise Port
Luxury Resort
Activities On-Site
Standard View
Ocean View
Concierge Level
Car Rental
Car Preferences (Frequent Renter Programs): Add-Ons
Car Category
Compact
Mid Size
Full Size
Luxury
Other
Package Tour
Country or Countries of Interest
Other Information
Notes
What hotels have you stayed in and enjoyed?
What cruiselines and resorts have you enjoyed before, if any?
What activities do you enjoy when travelling?
Sightseeing/History
Culture/Arts
Beach/Sun
Active/Sports
Wine/Culinary
Shopping
Spa
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