Thank you, for entrusting Bella Britt Travel to assist you with your Travel Destination Trip! Please allow 2-3 Days to follow back up!
New Customer Information Form
Date Completed:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Full Name:
*
First Name
Last Name
Phone Number:
*
Format: (000) 000-0000.
E-mail:
*
example@example.com
Destination of Interest:
*
Vacation Budget:
*
Travel Dates:
*
Travel Insurance?
*
Yes
No(If no, obtained signed wavier)
Number of Adults:
*
Other Travelers Contact Information: If more than 7 please leave the number in Notes below.
Rows
Full Name
Contact Number
1
2
3
4
5
6
7
Number of Children and Ages:
*
Air Travel Departure City:
*
Air Travel Seat Preference:
Economy
Window
Middle
Aisle
Business Class
First Class
Hotel/Resort Preferences:
Include # of Nights/ Include # of Rooms
Cruise Preferences:
Cruise Length: (Desired number of sail days)
Cabins in Mountains: (How many nights? How many people including kids?)
Car Rental?
Yes
No
Are you deposit ready?
Yes
No
Notes: Anything you will like to add.
*
Please verify that you are human
*
Submit
Should be Empty: