CLIENT INFORMATION

First name*

Middle name

Last name*

Preferred name

Phone number

Email*

Street Address

City

State

Zip

ABOUT YOUR TRIP

Where would you like to go?

When would you like to depart?

When would you like to return?

Are your dates flexible?

Yes

What is your departure city?

Is this vacation to celebrate anything special?

Who will be traveling? Please list all full names (including middle) and birthdays .

At what phase of planning are you in?

I’m just beginning the planning process.

We have dates, but no other details confirmed.

We have hotels and flights already booked.

What is your budget for all travelers? This just gives me a general starting point and can always be changed later. *

$7,500 - $10,000

$10,000 to $15,000

$15,000 to $20,000

$20,000 to $25,000

$25,000 to $35,000

$35,000 +

Will you be booking any portion of your trip with points? If so, which pieces?

What travel components would you like us to assist you with? Check all that apply.

Flights

Accommodations

Transportation (car rental, trains, etc.)

Excursions & tours

Insurance

Other

What best describes your desired accommodation style?

Luxury and exclusive

Boutique and charming

Centrally located and functional

Destination resort

Other

What are your amenity must-haves?

What options best describe your travel priorities? Check all that apply.

Local culture and education

Art and architecture

Food and wine

Adventure

Dramatic views and landscapes

Spa and wellness

Rest and relaxation

Is there anything else that you must do or see?

What else would you like me to know about your ideal vacation?

Who can we thank for referring you to us?

Would you like to be subscribed to our company newsletter?

Type
Draw

By signing, I understand that this is a legally binding contract.