Travel Planning Request Form

1

Lead Passenger's Details* This field is required.Full Name (must correspond to your travel document)

First Name

Last Name

2

Are you responding to/inquiring about a specific advertisement/email/promotion?

YES

NO

3

Tell Us about the email, advertisement or promotion your inquiring about...

4

Trip Information* This field is required.

Trip/Group Name

Reason for Travel

How many adults will be travelling? (approximate is OK)

How many children (under 11) will be travelling?

What are you celebrating? (Include actual date of celebration if known)

5

E-mail* This field is required.All written communication will be via email, so please use a valid, current email address

6

Your Birth Date* This field is required.This is required for the booking process. This is used to identify any promotions available based on your age (eg. Senior citizen rates, etc.)

Date

7

Mobile Number* This field is required.This is the number we will contact you on to confirm your booking

Area Code

Phone Number

8

Other Phone Number

Area Code

Phone Number

9

Best Time to CallWhat time of the day is best to call you to confirm your booking?

Hour

Minutes

10

Your AddressEnter your mailing address, including Zip code here (DO NOT include credit card information. We will obtain your payment information when we are on the phone to confirm your booking)

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

11

I would like to receive information from JADAR Travel, including details of offers and competitions

YESNO

12

Vacation Option* This field is required.Click on the drop down list to select travel option

13

Your Cruise RequestTell us about your desired cruise - sail date, cruise ship, desired destinations, etc. and we will find the cruise for you! (If you select multiple dates/ships, tell us your first choice)

We will find the options that are the closest match to your desire

14

Cruise Cabin option(s)You may choose one or multiple cabin types if you will be booking multiple cabins or if this is a group cruise

Interior (no window)

Ocean View/Garden View Window

Balcony/Varandah

Family Suite

15

Your State of residenceCruise lines often times offer discounts based on a passenger's state of residence. If you supply this information, we can use it to identify any offers or discounts you are eligible for.

Select state from list

16

We wish to travel from* This field is required.We recommend travelling from one airport to simplify planning. However, we can handle multiple departure points. Please indicate the primary departure port, as well as up to three others

17

We wish to travel to* This field is required.Select up to three destinations (if multiple destinations are selected, indicate in "Additional Information" section your first choice)

18

Outbound Date/TimeEnter outbound date and preferred departure time

Date

Hour

Minutes

19

Return DateEnter desired return date and preferred return time

Date

Hour

Minutes

20

Hotel/Resort Type (meal plan)* This field is required.Select an accommodation type from the list below.

21

Please check all that apply to you or any member of your partySome cruise lines offer discounts and promotions when certain qualifications are met. We will check for all those qualifications you select in order to maximize your savings

Active Military

Veteran

Work(ed) in the Travel/Cruise industry

Senior (over 65)

22

Maximum Number of Passengers in Room* This field is required.Enter the number of passengers (maximum 4) that will occupy this room

23

Cruise Dinner OptionThere are typically three dining options available on any cruise. Please make a selection (If you do not make a selection, you will default to the Flexible option)

24

Vacation Budget* This field is required.How much per person (total) are you thinking of paying for this vacation or cruise (estimate)

$1,000 - $1,500

$1,500 - $2,000

$2,000 - $2,500

$2,500 - $3,000

Over $3,000

Other (enter in comments below)

25

Payment Plan Option* This field is required.JADAR Travel & Cruise offers a FREE option for you to pay off your balance (after applying the deposit) in easy, convenient monthly installments. We also offer, for some packages, a 12 month vacation payment plan with Uplift. Ask for details when we talk

JADAR Free Easy Pay (after applying deposit and payment for Travel Protection Insurance)

12 Month Payment financing plan with Uplift (you pay over 12 months no matter when you start your vacation. No pre-payment penalty)

Full payment when I book (you will authorize full payment to be processed on your credit card at time of confirmation)

NO, I prefer to pay on my own schedule after making my deposit at time of booking (I know I risk automatic cancellation and loss of my deposit if I do not pay my balance as required by the cruise line)

26

How did you learn of us?

I am a returning client

Email

Social media (facebook, etc.)

Website/internet search

Someone referred me to you

27

Who may we thank for referring you?Please enter the name of the person who referred you so we can thank that person on your behalf. Welcome to an awesome travel experience!

First Name

Last Name

28

Do you have or plan to get a US Passport?* This field is required.If you plan to travel internationally, a passport (US or otherwise) may be required of every passenger for your trip. Please ensure your passport will not expire within 6 months of the sail date.

YES

NO

29

If not a US passport, what country issued your passport?

30

Vacation Protection Insurance* This field is required.We strongly recommend this option! Do you wish to include cost of insurance for this group? Contact us for more details, including coverage limits and price.

YES, I want Vacation Protection Insurance (RECOMMENDED)

NO, I decline protection

I'm Not Sure - let us talk about it when you call to confirm booking

No thanks - I already have insurance or will purchase Insurance elsewhere

31

Additional Information:Enter any information you wish us to know (Eg. any special requests or instructions pertinent to this booking, or any thing or question you wish to discuss with us when we get on the line to complete booking)

32

Select your preferred Travel Expert (optional)Please select the name of the expert you have talked with and wish to work with for this trip request

33

Coupon CodeIf you have an eligible coupon code, enter it here

34

By submitting this form, I am certifying that I am requesting an individual or group travel quotation.* This field is required.