GENERAL TRAVEL INQUIRY FORM
Thank you so much for reaching out to me! My services come at no extra cost to you! I will work hard to get you the best price available for your upcoming travel. Please fill out this form in it's entirety so I can better assist you. I will be in touch within 1 to 2 business days. Please add anna@livefortodaytravel.ca to your safe-sender list to prevent any email correspondence from going to your junk/spam folder.
ANNA BORSUK
TRAVEL AGENT
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
*
First Name
Last Name
Email
*
Phone Number
-
Area Code
Phone Number
Preferred Method of Contact - Check all that apply.
*
Email
Phone Call
Text Message
Facebook Messenger
U.S. Military Involvement?
*
No
No but someone traveling with me is
Yes I am Active Duty
Yes I am Retired
Yes I am a Military Spouse
Other
Travel Information
Where would you like to go
*
Departure Airport
*
If not flying, put Driving from (city)
Travel Start Date
*
Month/Day/Year
Travel End Date
*
Month/Day/Year
Are your travel dates flexible?
Yes
No
How many travelers age 18+
*
Based on Travel Start Date
How many travelers age 10-17
*
Based on Travel Start Date
How many travelers age 3-9
*
Based on Travel Start Date
How many travelers age 2 or Under
*
Based on Travel Start Date
If there are multiple families/couples traveling, how would you all like to be split into rooms? If anyone is military, please indicate which room they will be in!
Example: Room One = 2 adults & 5 year old, Room Two (military) = 1 adult & 8 year old, or We prefer a large suite that will sleep everyone, etc.
What is your Total Vacation Budget?
*
$2,000 - $4,000
$4,000 - $6,000
$6,000 - $8,000
$8,000 - $10,000
$10,000+
Other
What kind of Vibe are you looking for? Check All that Apply.
*
Kid/Family Friendly
Culture/Culinary
Adventure/Active
Off the Beaten Path
Romance
Rest & Relaxation
Nightlife/Party
Health & Wellness
Clothing Optional
Adult Only Singles
Adult Only Couples
Other
Type of Travel? Check All that Apply.
*
Family Vacation
Wedding
Solo Travel
Honeymoon
Business Travel
Girl's Trip
Group Travel
Guy's Trip
Couple's Getaway
All Inclusive
Cruise
DIsney Vacation
Universal Package
Flight and hotel package
Other
Any Celebrations?
Birthday
Anniversary
Graduation
Other
Anything you absolutely must see or do?
Example: Magic Kingdom, The Eiffel Tower, Snorkeling, Swim with Dolphins, Zip line, etc.
Anyone require handicap accessible accommodations, have special needs, dietary restrictions, allergies, or medical concerns you want me to be aware of?
Example: We need a wheelchair accessible room, child allergic to peanuts, etc. If multiple rooms - please indicate which
Any other Requests, Preferences, or Information you want me to know?
Example: We prefer to fly first class on Delta, ocean views, and a king size bed, etc.
Please verify that you are a human.
*
Submit
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