Client Intake Form
Please fill out all sections of the form and be as complete as possible for the best experience!
Full Name as it shows on your passport.
Prefix
First Name
Middle Name
Last Name
Suffix
Birth Date (as shown on passport or drivers license)
-
Month
-
Day
Year
Date
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing Address (if not same as mailing address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
How do you prefer to be contacted?
Phone (I am deaf or hard of hearing)
Phone (I am hearing)
Text
Email
In Person
Any method
Is this a special occasion trip?
NO
Yes, Wedding
Yes, Honeymoon
Yes, Anniversary
Yes, Babymoon
Yes Girls Getaway
Yes Mans Getaway
Yes Group trip
A different special occasion that merits special attention
Any other details about this special trip we should know about?
How many people will be traveling (include yourself in this number) - if known
Others traveling with you (as shown on passport):
Prefix
First Name
Middle Name
Last Name
Suffix
Prefix
First Name
Middle Name
Last Name
Suffix
Prefix
First Name
Middle Name
Last Name
Suffix
Who referred you or how did you find us?
Do you have a date or a time frame in mind when you wish to take this trip?
Where are you thinking of traveling? What activities interest you and the people you are traveling with? What is the reason for this trip? Please give us as much detail as possible describing the trip you wish to take, what you seek to find on this trip, what experiences you would like to have. The more detail you provide us with, the better we are able to help you! Even if you can tell us a dream of a place you wish to go it may exist!
Tell us about the last trip you took. Where you went. How long you went for? What experiences you had. Where you stayed? What hotels or places and restaurants did you enjoy? What were your favorite and least favorite things about it? Did you have a good time or not? Why did you go?
What differences would you like to see in this trip? What prompted you to take a trip? What prompted you to seek a travel consultant?
Do you have any special accommodations or special needs you would like us to know about? Any known allergies? Any special requests? What kinds of foods do you like/not like? What is your biggest pet peeve or dislike about traveling?
Please describe yourself. We want to know who YOU are, what kind of person you are - are you a decisive or indecisive person? Patient/Impatient? Are you scared of flying or do you have any fears about cruises? are you afraid of anything? What worries you most about traveling? Is there any type of trip, place or hotel that you definitely will not consider?
Select all that interests you or that could apply to this trip:
Beaches
Culture
Flying
Rail
Renting a car
Budget Hotels
Moderate Hotels
Luxury Hotels
All Inclusive
Cruises
Nudism
Art
Scuba Diving
Kayaking
Snorkeling
Castles
Glamping
Yurts
International
Domestic
I have passport
No passport yet
Climbing
Horseback riding
Excursions
Parties
Nightlife
Dancing
Casino
Shopping
Paddle boarding
hobie cats
jet skiing
Fine Dining
Super Inclusive
LGBT friendly
onsite Wedding
Private tours
Small group tours
Large group tours
Foodie
History
Other
If budget were no object where would you go?
*
Do you have a budget in mind?
*
May we ask who referred you to us?
*
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