Client Qualification Form

Travel Client Qualification Form
Full Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Preferred Method of Contact: [] Phone [ ] Email Text Best Time to Contact:
Best Time to Contact
Are there any special needs or accessibility requirements?

Yes ( )

No ( )

If yes, please specify:
Ages of Travelers
Number of Travelers
If yes please specify
Destination(s) of Interest: Preferred Travel Dates:
Preferred Travel Dates

MonthDayYear
Date
Destinations of Interest
Are your dates flexible? [ Yes [ No Trip Duration: Travel Purpose: [ ] Leisure [ ] Business [ ] Family Vacation [] Honeymoon ] Other:
Trip Duration
HotelResortCruiseVacation Rental/VillaOther
FlightCruiseTrainCar RentalPrivate DriverTour
Do all travelers have passports
AdventureCultureRest and RejuvenationOff the beaten pathOther
3 stars4 stars5 starsNo preference
Activities Interests
Preferred Airlines if applicable
EconomyPremium EconomyBusiness ClassFirst Class
Estimated Budget Per Person
Additional Notes Special Requests
Next Steps: [ ] Schedule Consultation Call Receive Custom Travel Itinerary [] Review & Confirm Travel Plans
Signature
Date

MonthDayYear
Date
Should be Empty: