Customer Information Form
Client Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
County
Postal Code
Holiday Budget
*
Number of Adults
*
Number of Children
Children Ages
Holiday Start Date
-
Month
-
Day
Year
Date
Holiday End Date
-
Month
-
Day
Year
Date
Or flexible dates?
Please enter all that apply
Destination(s) of Interest
*
Do you have insurance?
*
Yes
No (will sign waiver)
Air Travel
Complete if applicable to your holiday
Departure Airport
Preferred departure/arrival time
Please specify if you have a preference
Airline Preference (Frequent Flyer Programs)
Seat Preference:
Economy
Extra Leg Room/Premium
Business Class
First Class
Aisle
Middle
Window
Bulkhead
Forward
Wing
Cruise Vacation
Complete if interested, leave blank if you're not interested.
Cruise Preferences (Frequent Cruiser Programs)
Cruise Itinerary
Cruise Length
Pre and Post Cruise Nights
Yes
No
Cabin Class
Beverage Plan
Yes
No
Beverage Plan Type
Hotel and Resort Vacation
Complete if applicable to your holiday
Number of Nights
Hotel Preferences (Frequent Guest Programs)
# of Rooms/Arrangement
Room type preference:
Standard Room
Garden View
Ocean View/Front
Standard View
Suite/Junior Suite
Apartment
Other
Features:
All Inclusive
Half Board
Self-catered
Adults Only
Family Friendly
On the Beach
Near City Center
Kids Club
Near Air/Cruise Port
Luxury Resort
Activities On-Site
Other
Car Rental
Complete if required
Car Preferences (Frequent Renter Programs)
Car Category
Compact
Mid Size
Full Size
Luxury
Other
Add-Ons
Package Tour
Complete if applicable
Country or Countries of Interest
Country or Countries of Interest
Escorted
Independent Activity Level
Other Information
What hotels have you stayed in and enjoyed?
What cruiselines and resorts have you enjoyed before, if any?
What activities do you enjoy when travelling?
Sightseeing/History
Culture/Arts
Beach/Sun
Active/Sports
Wine/Culinary
Shopping
Spa
Relaxation
Other
Additional Notes
Submit
Should be Empty: