Client Intake Form

Client Travel Intake Form

Here at My Black Escape we are so excited to assist you in curating some of your best experience. We use this form to help us get to know you a bit better, so your experience is tailored to you.
Full Name

First NameLast Name
Email Address
example@example.com
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Method of Contact
Are you looking for assistance with existing travel plans or planning new travel?
How much of this trip would you like us to plan? (tick all that apply)
Where do you want to go? (If you have somewhere in mind)
What type of experience are you looking for? (tick all that apply)

Other
Dates for travel (M/DD/YY) Please attach a copy of your travel itinerary (flight, train, etc.)

Cancelof
If you traveled recently, Where did you go? What did you like about it? What's the one thing you would have changed about it? The more details the better! Tell us your favorite destinations, the activities you liked, how you felt in these places, what you liked most - food/culture/the people etc.)
Where would you like to go that you haven't been yet?
Do you have any big travel goals or "Bucket List" places you'd like to explore?
What hotels have you stayed at that you loved?
Is there a special reason for the trip?

Other
What are your top three priorities for this trip?
How long do you have for this trip?
To help me better understand your budget, what would you like to spend per night on a hotel?
Names of all guests & ages (if children are involved). Please include traveler names, Ages of all including children, dietary requirements, other allergies etc.
Should be Empty:

Client Travel Intake Form