Travel Inquiry Form

Travel Inquiry Form

Please fill out the form below to start the planning process.
Full Name (as it appears on photo ID)*

First NameLast Name
Preferred Name
Date of Birth*

MonthDayYear
Month-Day-Year
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How do you prefer to be contacted

PhoneTextEmailVideo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact Information

Please provide the name and phone number of an emergency contact person.
Emergency Contact Name

First NameLast Name
Relationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are you traveling alone or with others?

AloneWith Others
Travelers
Do travelers have passports, if applicable?

YesNoUnsureNot needed
Travel Preferences

Please indicate your travel preferences below.
Preferred Travel Destination
Preferred Travel Dates From

MonthDayYear
Month-Day-Year
To

MonthDayYear
Month-Day-Year
Are Your Dates Flexible?

YesNo
Airport &/or Port Preference
Travel Style
e.g. cabin & seat preference, direct flights, red eye, # of layovers, etc.
Preferred Brands- Airline, Hotels and/or Cruise Lines & Loyalty Program Information
Room/Cabin Preference
e.g., All-inclusive, Ocean View, Balcony, etc.
Excursions/Activities of Interest
e.g., Luau, Dinner Cruise, Snorkeling, etc.
Other Travel Interests and Locations
Bucket list trips, group trips, retirement celebrations
How would you describe the perfect trip?
Health and Safety

Please answer the following health and safety questions.
Any special needs?
(e.g. health conditions, allergies, limited mobility, dietary, first time traveler)
Additional Information
Additional Comments (Special Occasion or Celebration?)
Email
example@example.com
How Did You Hear About Life Is Short- Travel?
Previous client, referral, Facebook, Travel Leaders, etc.
For Questions Please Email, Call or Text

Becky@lifeisshort.travel 509.949.3290
Should be Empty:

Travel Inquiry Form

Emergency Contact Information

Travel Preferences

Health and Safety

Additional Information

For Questions Please Email, Call or Text