[Please provide ALL information exactly as seen on each document, including Middle name if it is present. Thank you]
Full Name (as seen on document):_________________________________
Date of Birth:________________________________________________
Birthplace (State-if born in US, Country-if not born in US):_______________
(Document needed for identification if no Passport is available)
2-DRIVERS LICENSE
Full Name (as seen on document):_________________________________
Address on License:___________________________________________
Expiration Date:_____________________________________________
(Document needed for identification for Resident Special; Document needed for identification if no Passport is available)[If no Passport is available for married person, a marriage license is needed. I will explain]
3-CITIZENSHIP
Are you a US Citizen?______(if not, what country are you from and are you a US Resident? Explain) _________________________________________
(Special Identification is needed if not a US Citizen)
4-PASSPORT
Do you hold a US or Canadian Passport? Which one?___________________
Full Name (as seen on Document):_________________________________
Expiration Date:____________(Only form of identification needed if you have one, unless Resident Special; Passport must be valid within 6 months of last day of cruise)
5-CURRENT ADDRESS
Address including Zip Code:__________________________________(Zip Code used in conjunction with your credit card for Billing Address)
6-PHONE NUMBERS
Home:_______________Cell:______________Work:________________
7-EMERGENCY CONTACT
(Name of person not sailing with you. Please leave a copy of your travel documents; the ship’s name, cruise line and travel dates; and my contact information with them)
First and Last Name:__________________Contact Number:____________
8-EMAIL ADDRESSES Home:_________________Work:_______________
9-PAST CRUISE LINES SAILED___________________________________
(Past Passenger numbers, if available; zip code of address you were residing at if not current address when you sailed)___________________________
PORTS OF CALL YOU HAVE VISITED____________________________________________________
10-SPECIAL RATES POSSIBLE (Circle all that apply)
Military, Civil Service, Firefighter, Police Officer, Teacher, AARP
11-CABIN MATE or MATES
Name:______________________Relationship:_____________________
12-OTHERS SAILING IN YOUR PARTY
Name:__________________________Relationship:_________________
13-SPECIAL OCCASION
Anniversary Date:________________Family Reunion, etc:_____________
14-SPECIAL NEEDS
Dietary:______________________Medical:_______________________
15-PREFERENCES (List up to 3 for each)
Cruise Line:_________________________________________________
Cabin Type (inside, outside, balcony, suite):_________________________
Bed Configuration (together or apart):_____________________________
Number of Nights:____________________________________________
Port of Departure:____________________________________________
Itinerary:__________________________________________________
Ports interested in visiting:______________________________________
Date of Departure:____________________________________________
Dining Preference (early, late or daily choice):________________________
Per day Budget with taxes & fees included:_______Overall Budget:________
Any other important information I should know:______________________
Referred by: ________________________________________________
Although this may seem lengthy, the above information provides me with all the information needed to get you the best price available, as well as providing me with your current travel documentation so I can advise you as to what you will need for sailing on your cruise. I will need every line filled out. If you do not have a particular type of documentation, please say “Do not have”.
Thanks so much-
Cindy
Cindy Frazer
Cruise and Vacation Specialist
941-350-0284
[email protected]
Please note: Pricing is not guaranteed until cruise is put on hold or deposit is made. I will call you or you can text me your Credit Card information for deposit. Credit Card information that will be needed will be: Full name on credit card, credit card type, credit card number, expiration date, security code, billing zip code.
