Cruise & Land Booking

MARY BELYSKI, TRAVEL SPECIALIST

Thank you for contacting me regarding your travel needs. Please fill out this form so that I can proceed with your booking! The more I know about you, your likes & dislikes, the better equipped I will be to plan a trip for you that you will be truly happy with. Thank you for taking the time to fill this out. I look forward to working with you!
Client Information:

List each person that will be traveling in the same stateroom or room with you.
Please provide all names exactly as they appear in your passport used for travel. Failure to provide accurate information may result in additional fees. If this is for Domestic Travel (within USA), you may provide your name as EXACTLY as written on your ENHANCED DRIVERS LICENSE. If you are using a Passport, which you can for Domestic Travel, then write it as written exactly on your passport. FAILURE TO PROVIDER ACCURATE INFORMATON WILL RESULT IN CHANGE FEES YOU WILL HAVE TO PAY!
Your Name (FIRST GUEST - LEAD PASSENGER) *

PrefixFirst NameMiddle NameLast NameSuffix
Birth Date*

MonthDayYear
E-MAIL ADDRESS*
PHONE NUMBER HOME
CELL PHONE NUMBER
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
COUNTRY OF BIRTH
What Country was Passport Issued
Passport Number
If you do not have a passport right now, skip this part.
LEGAL NAME EXACTLY AS SPELLED ON PASSPORT-MAKE SURE YOU ARE PUTTING THIS EXACTLY HAS WRITTEN ON YOUR PASSPORT
Date Passport Issued

MonthDayYear
Passport Expiration Date

MonthDayYear
Do you have a Known Traveler Number, Global Entry Number, or Nexus Number?
Name EXACTLY as written on your Known Traveler Number, Global Entry Number, or Nexus Number
Your Known Traveler #, Global Entry #, or Nexus #
Expiration Date of your KTN, Global Entry #, or Nexus #
Emergency Contact Name

PrefixFirst NameMiddle NameLast NameSuffix
Phone Number

Area CodePhone Number
Relationship of Emergency Contact to You
Emergency Contacts's Email Address
Spouse/Partner/Other (SECOND GUEST)

PrefixFirst NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
PHONE NUMBER HOME
PHONE NUMBER CELL
EMAIL ADDRESS
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Country of Birth
What Country was Passport Issued
Passport Number
If you do not have a passport right now, skip this part.
LEGAL NAME EXACTLY AS SPELLED ON PASSPORT
What Country was Passport Issued
Date Passport was Issued

MonthDayYear
Passport Expiration

MonthDayYear
Do you have a Known Traveler Number, Global Entry Number, or Nexus Nuumber?
Name EXACTLY as written on Known Traveler #, Global Entry #, or Nexus #
Expiration date of your Known Traveler #, Global Entry #, or Nexus #
Expiration Date of your KTN, Global Entry #, or Nexus #
PASSENGER 3

PrefixFirst NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
RELATIONSHIP TO YOU
E-mail
example@example.com
Country of Birth
What Country Was Passport Issued
Passport Number
Date Passport was Issued

MonthDayYear
Passport Expiration

MonthDayYear
Do you have a Known Traveler Number, Trusted Traveler Number, or Global Entry Number
Name as written on your KTN or Trusted Traveler Number or Global Entry Number
Your KTN, TTN, or GEN #
Expiration Date of your KTN, TTN, or GEN #
PASSENGER 4

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
RELATIONSHIP TO YOU
E-mail
example@example.com
Country of Birth
What Country was Passport Issued
Passport Number
Date Passport was Issued

MonthDayYear
Date Passport Expires

MonthDayYear
Do you have a Known Traveler Number, Trusted Traveler Number, or Global Entry Number
Name as written on your KTN or Trusted Traveler Number or Global Entry Number
KTN, TTN, GEN #
Expiration Date of your KTN, TTN, or GEN #
PASSENGER 5

PrefixFirst NameMiddle NameLast NameSuffix
Birth Date

MonthDayYear
RELATIONSHIP TO YOU
Country of Birth
What Country was Passport Issued
Passport Number
Date Passport Issued

MonthDayYear
Date Passport Expires

MonthDayYear
Do you have a Known Traveler Number, Trusted Traveler Number, or Global Entry Number
Name as written on your KTN or Trusted Traveler Number or Global Entry Number
Your KTN, TTN, or GEN #
Expiration Date of your KTN, TTN, or GEN #
Will anyone else be traveling with you?
What Type of Stateroom Would you Like and How Many Staterooms Do You Need:
Will you be celebrating a special occasion?
DATE OF YOUR SPECIAL OCCASION

MonthDayYear
Name of the person or person(s) celebrating the special occasion
Will you be celebrating another special occasion?
DATE OF YOUR SPECIAL OCCASION

MonthDayYear
Name of the person of person(s) celebrating the special occasion
Will you be celebrating another special occasion?
DATE OF YOUR SPECIAL OCCASION

MonthDayYear
Name of the person of person(s) celebrating the special occasion
Have You Cruised Before?
Please list your name and each cruiseline you have been on before & Ship Brand Name
Does anyone in your group have frequent flyer/member ship accounts with airlines/cruise lines/hotels etc.?
If yes, please list the name, your membership #, and the level (if the applies)
Does anyone in your group have special needs, dietary needs, special request? Example Gluten Free, Food Allergies, or Other.
If Yes, Please Explain Who and What are Their Special Needs:
Does anyone have any special medical needs: Example, will be bringing CPAP machine, Oxygen, Diabetic, Need W/C assistance, other.
If Yes, Please Explain Who and What are Their Special Needs:
Do you need to rent any special equipment: Wheelchair, Walker, Scooter?
If Yes, Please Explain Who and What are Their Special Needs:
Will you be bringing special equipment onboard: Scooter, walker, wheelchair, or other?
If Yes, Please Explain Who and What are Their Special Needs:
What is the closest airport to you?
Which star hotel/resort do you usually book?
How many cabins will you need ?
What type of cabin would you like?

Please give me your preferences of cabin location?

Rows	Yes	No	No Preference
As high up on the ship as possible
As low on the ship as possible
As close to the elevators as possible
Stern / Rear of the ship
Middle
Bow / Front
Need joining cabins
As inexpensive as possible

What Type of Activities Do you Enjoy to Do?

Rows	Yes	No	No Preference
Culinary
Casino
Shopping
Scuba
Wine Tasting
Alcohol Tasting
Shows on board
Spas
Fitness
Ports Visit Beaches
Port Tour of Island
Dolphin Encounters

What is the sleeping configuration that you would like?

Rows	Yes	No
1 King/Queen
2 Twins
Bunk beds
Crib
Special Needs Bed
Bed Together
Bed Apart

Do you have a budget in mind for this cruise?
If yes, what is the budget per person, per day?
Is this the budget for cruise only, or should it include other expenses, such as air, transfers, hotel, excursions, and travel insurance?
Please answer as many as you can, as this will tell me a lot about your likes and dislikes.
Occupation of each Traveler and Name
Occupation of each Traveler and Name
Dining Preference:
Do you smoke?
Do you drink any alcohol?
YesNo
Please list the name of the person, and indicate military, police or firefighter:
Where Do You Want To Go?
Are Your Dates Flexible? Please give the range of dates you can travel:
Date You Would Like to Travel, FROM:

MonthDayYear
Date You Would Like to Return, TO:

MonthDayYear
How Long Would You LIke to Travel:
If you have specific ports you would like to travel to, please list them here:
Will you need a hotel pre or post trip? If so, How many days do you need pre and post trip?
Do you need a quote for air?
Is there anything else you feel we need to know:
Thank you for filling out this form. This will let us get to know you better. Make sure you hit the submit button.

We promise you will have a Dream Vacation! Mary Belyski, Dream Vacations.
Should be Empty:

MARY BELYSKI, TRAVEL SPECIALIST

Client Information:

Thank you for filling out this form. This will let us get to know you better. Make sure you hit the submit button.