CRAZY COCONUTS TRAVEL INQUIRY FORM

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
3
Phone Number
Area Code
Phone Number
4
Preferred Method of Contact - Check all that apply.* This field is required.
Email
Phone Call
Text Message
Facebook Messenger
5
U.S. Military Involvement?* This field is required.
No
No but someone traveling with me is
Yes I am Active Duty
Yes I am Retired
Yes I am a Military Spouse
Other
6
Where would you like to go* This field is required.
7
What type of accommodation do you prefer?
Moderate 1-2 star hotels
First Class 3-4 star hotels
Luxury 5+ star hotels
8
Departure Airport* This field is required.
If not flying, put Driving from (city)
9
Travel Start Date* This field is required.
Month/Day/Year
10
Travel End Date* This field is required.
Month/Day/Year
11
Are your travel dates flexible?
Yes
No
12
How many travelers age 18+* This field is required.
Based on Travel Start Date
13
How many travelers age 10-17* This field is required.
Based on Travel Start Date
14
How many travelers age 3-9* This field is required.
Based on Travel Start Date
15
How many travelers age 2 or Under* This field is required.
Based on Travel Start Date
16
Do you have a passport and have you checked your passport expiration date?This is a reminder to be aware of your passport expiration date! There are many countries that do not allow entry if the expiration date on the passport is 6 months or less from the LAST day of the trip
17
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.
18
What is your Total Vacation Budget?* This field is required.
$2,000 - $4,000
$4,000 - $6,000
$6,000 - $8,000
$8,000 - $10,000
$10,000+
Other
19
What kind of Vibe are you looking for? Check All that Apply.* This field is required.
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
20
Type of Travel? Check All that Apply.* This field is required.
Family Vacation
Wedding
Solo Travel
Honeymoon
Business Travel
Girl's Trip
Group Travel
Guy's Trip
Couple's Getaway
Other
21
Any Celebrations?
Birthday
Anniversary
Graduation
Other
22
Anything you absolutely must see or do?
Example: Magic Kingdom, The Eiffel Tower, Snorkeling, Swim with Dolphins, Zip line, etc.
23
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
24
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.
25
Please verify that you are a human.* This field is required.
Should be Empty: