EmailMe Form - Ocean Cruise

PLEASE DO NOT ABBREVIATE!

TRAVEL WITH SERENITY LLC
(770) 685-4398
glenda@travelwithserenity.net
http://travelwithserenity.net
Stockbridge, GA 30281
Current Date *
MM / DD / YYYY
PAX No. 1 - Lead Person *
Prefix First Last Suffix
Date of Birth *
MM / DD / YYYY
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Cell Phone *
### - ### - ####
EMAIL *
US Citizen *
Yes
No
City & State of Residence *
Are you?
Active/Retired Military
Active/Retired Firefighter
Active/Retired Police
55+ Years Old
City & State of Residence *
PAX No. 2, List all Information
PAX No. 2
Prefix First Last Suffix
Date of Birth
MM / DD / YYYY
Address, if different

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Cell Phone for PAX No. 2
### - ### - ####
EMAIL for PAX No. 2
US Citizen
Yes
No
City & State of Residence
Are you?
Active/Retired Military
Active/Retired Firefighter
Active/Retired Police
55+ Years Old
City & State of Residence
PAX No. 3, List all Information
PAX No. 3
Prefix First Last Suffix
Date of Birth
MM / DD / YYYY
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Cell Phone for PAX No. 3
### - ### - ####
EMAIL for PAX No. 3
US Citizen
Yes
No
City & State of Residence
Are you?
Active/Retired Military
Active/Retired Firefighter
Active/Retired Police
55+ Years Old
Loyalty Number if Prior Traveler With This Cruise Line
PAX No. 4, List all Information
PAX No. 4
Prefix First Last Suffix
Date of Birth
MM / DD / YYYY
Address, if different

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Cell Phone for PAX No. 4
### - ### - ####
EMAIL for PAX No. 4
US Citizen
Yes
No
City & State of Residence
Are you?
Active/Retired Military
Active/Retired Firefighter
Active/Retired Police
55+ Years Old
Loyalty Number if Prior Traveler With This Cruise Line
CRUISE INFORMATION -- CONTACT OUR OFFICE FOR A GROUP
Preferred Cruise Line & Ship if Known *
Departure Port & Cruise Destination(s) *
Preferred Departure Date
MM / DD / YYYY
No. of Cruise Nights
Maximum Budget Per Person *
$ Dollars . Cents
Is an accessible stateroom required? *
Yes
No
If GROUP BOOKING, how many STATEROOMS per CATERORY

Interior

Ocean View

Balcony

Groups will be quoted for double occupancy only -- interior, ocean view, balcony.
If INDIVIDUAL BOOKING, Stateroom Choice
Interior
Ocean View
Balcony
Add-Ons - No Service Retainer if Added With Initial Booking
Travel Protection via supplier
Tranfers from/to airport via cruise supplier on days of cruise
One Night Pre-Stay Hotel via cruise supplier
Two Night Pre-Stay Hotel via cruise supplier
Three Night Pre-Stay via cruise supplier
Quote Inquiry Acknowledgment *
I am requesting that Travel With Serenity book my cruise.
Traveler(s) Responsibility *
I/We understand it is our responsiblity to be aware and to comply with travel requirements, documents, passport, VISA, country entry, health, penalties that result from denied boarding/travel, etc.
Comments:

Interior
Ocean View
Balcony

We provide planning and coordination of travel services for groups and individuals -- all-inclusive, cruise, tour, or rail travel services for alumni, anniversary, church, civic, community, getaway, graduation, retirement, reunion, specialty (wedding, honeymoon, romance) groups, etc. Travel where you want, when you want and travel with serenity!

PAX No. 2, List all Information

PAX No. 3, List all Information

PAX No. 4, List all Information

CRUISE INFORMATION -- CONTACT OUR OFFICE FOR A GROUP