EmailMe Form - Laurel Travels - Client Travel Form

Name *

First Last

Name

First Last

Phone *

### - ### - ####

Select the Best Time to Call *

Email *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Select the Purpose of the Trip *

If "other" please specify

Will You need Airfare? *

Date starting vacation *

MM / DD / YYYY

Date returning home *

MM / DD / YYYY

Number of Adults *

Number of Children

Home *

Destination *

Budget per person *

Name (as it appears on passport), Date of birth and Age *

Will You need Lodgings? *

Please specify a specific hotel (if any) you would like to stay and specify how many nights and bedding preference (ex: King bed)

Will You need Car Rental? *

CAR RENTAL: Where would you like to PICK UP your vehicle? (ex: home airport)

CAR RENTAL: Where would you like to DROP OFF your vehicle? (ex: home airport)

CAR RENTAL: What type of vehicle?

CAR RENTAL: specify insurance type

LUXURY TRANSPORTATION ONLY: What type of vehicle?

LUXURY TRANSPORTATION ONLY: What type of event?

If "other" please specify

CRUISE ONLY: Please list departure port (or N/A) *

CRUISE ONLY: If you are a your frequent cruise traveler, please specify membership # (ex: Carnival, Royal Carribean)

CRUISE ONLY: Please list your intended cruise line, destination and ship (if known)

CRUISE ONLY: Do you want a drink packages?

CRUISE ONLY: Do you prefer to early or late dining?

Do you have a bedding preference?

Would you like travelers insurance? *

Comment/Questions

Special Requests (ex: vegan restaurants, scuba diving)