EmailMe Form - All-Inclusive Vacation

EmailMeForm

Travel With Serenity LLC
(770) 685-4398
glenda@travelwithserenity.net
Stockbridge, GA 30281
Henry County Chamber of Commerce, Member
Current Date *
MM / DD / YYYY
** PLEASE COMPLETE INFO FOR EACH TRAVELER **
PAX No. 1 - Lead Traveler
Name as on Passport *
First Middle Last
Date of Birth *
MM / DD / YYYY
Email *
Cell Phone *
### - ### - ####
Are You a US Citizen *
Yes
No
Departure Airport/City & State
Do you have a valid US Passport? *
Yes
No
Applied For
Passport Expiration
MM / DD / YYYY
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
PAX No. 2
Name
First Middle Last
Date of Birth
MM / DD / YYYY
Email for PAX No. 2
Cell Phone
### - ### - ####
Are You a US Citizen
Yes
No
Departure Airport/City & State
Do you have a valid US Passport?
Yes
No
Applied For
Passport Expiration
MM / DD / YYYY
Address, IF DIFFERENT

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
PAX No. 3
Name
First Middle Last
Date of Birth
MM / DD / YYYY
Email for PAX No. 3
Cell Phone
### - ### - ####
Are You a US Citizen
Yes
No
Departure Airport/City & State
Do you have a valid US Passport?
Yes
No
Applied For
Passport Expiration
MM / DD / YYYY
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
PAX No. 4
Name as on Passport
First Middle Last
Date of Birth
MM / DD / YYYY
Email for PAX No. 4
Cell Phone
### - ### - ####
Are You a US Citizen
Yes
No
Departure Airport/City & State
Do you have a valid US Passport?
Yes
No
Applied For
Passport Expiration
MM / DD / YYYY
Address, IF DIFFERENT

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
TRIP INFORMATION
Travel Destination (List One)
Reason for Travel
Group/Organization, if Applicable
Each room lead will select options as applicable when appropriate.
Check-In Date *
MM / DD / YYYY
Check-Out Date *
MM / DD / YYYY
Maximum Price Per Person: Resort & Transfers (if included) *
$ Dollars . Cents
Room Location Preferred *
Garden View
Ocean View
Oceanfront
Swim Up
Overwater Bungalow
Flights *
I/We will book/arrange flights.
TWS to book flights provided by supplier.
It is suggested that travelers self-book flights in order to immediately handle flight issues that may arise.
Travel Protection *
Yes, include pricing for travel protection. (Optional, may be accepted or declined.)
No, do not incude pricing for travel protection.
Preferred Resort
Resort Preference *
Adults Only
Group
Family/Friends
Multi-Generational
Couple
Solo
How many rooms anticipated? *

Single

Double

Triple

Quad
How many adults anticipated? *
How many children anticipated? *
Payment Designation *
One credit card will be used.
Two+ credit cards will be used.
Comments/Explanations
Travel Retainer Acknowledgment *
This is my one free quote request for the all-inclusive resort stay.
There is minimum non-refundable retainer of $35.00 for each additional quote due via PayPal to glenda@travelwithserenity.net or Cash App at $glenda1119 and will be billed in advance in order to proceed.
Traveler Acknowledgment *
As travelers I/We are responsible for being aware of eligibility and complying with ALL travel documents, guidelines, country entry requirements, and any penalties that result from denied boarding or refused entry.
Signature *
Clear

Single
Double
Triple
Quad

** PLEASE COMPLETE INFO FOR EACH TRAVELER **

PAX No. 1 - Lead Traveler

PAX No. 2

PAX No. 3

PAX No. 4

TRIP INFORMATION

PLEASE COMPLETE INFO FOR EACH TRAVELER