Client Profile

Client Profile

Thank you for choosing Travel by Susan for your travel needs and more.
Date

MonthDayYear
Date
Name - As printed on your legal identification *

PrefixFirst NameMiddle NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number - Home

Area CodePhone Number
Phone Number - Cell *

Area CodePhone Number
Do you have a passport?

YesNo
If YES Passport expiration date.
Are you interested in information in regards to a passport?

YesNo
Air Travel
Flight information

Round TripOne Way
Do you have a Airline Preference?
Airline Rewards - List with # and Airline name
Air Seating Preference

AisleWindowOther
Any Special Accommodations?

Yes, please list below.No
Hotel
Do you have a Hotel Preference?
Hotel Rewards - List with # and Name of Hotel
Hotel Room Preference

Non-SmokingDouble - BedsKing BedRoll- AwayOther
Please list number of each room you will need.
Car Rental
Do you have a Rental Agency Preference
Rental Care Rewards - List with # and Agency Name
Car Preference

EconomyCompactMid-SizeFull- SizeSUVConvertible
Do you have any other membership that will allow you an extra discount? List here please.
Booking Information
Departure Date

MonthDayYear
Date
Return Date

MonthDayYear
Date
Estimate Budget: per person
What are we booking?

HotelFlightCruiseTourEntertainment ticketsCar RentalOther
All Inclusive

YesNo
Departure Airport
Arrival Airport
Do you want travel Insurance

YesNo
Cruising Information
Would this be your first cruise?

YesNo
Preferred Port
Cabin Type

Inside CabinOcean-view CabinBalconyMini-SuitesSuites
Please list cabin type and number of each cabin.
Preferred Cruise Line
Have you cruised with this cruise line before?

YesNo
Rewards Points
Any Special Accommodations
Travelers Information

This section needs to be completed for every traveler (Adult and Children)
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Total # of Adults 18 or older on date of travel
Total # of Children
Will you be traveling with Pets?

YesNo
Additional Travelers
Will you need Transport?

YesNo
Any Travelers with military background?

YesNo
Any Travelers affiliated with organization that will provide a special discount? Please list.
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I appreciate you taking the time to complete our intake form. Once you click the submit button your information will be sent directly to me to start working on your quote.

Once again, Thank You.
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Client Profile

Air Travel

Hotel

Car Rental

Booking Information

Cruising Information

Travelers Information