DEPARTURE YEAR
2012 2013
DEPARTURE MONTH
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
DEPARTURE DATE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
DEPARTURE TIME
6A 7A 8A 9A 10A 11A 12P 1P 2P 3P 4P 5P 6P 7P 8P 9P 10P 11P
RETURN MONTH
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
RETURN DATE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
RETURN TIME
6A 7A 8A 9A 10A 11A 12P 1P 2P 3P 4P 5P 6P 7P 8P 9P 10P 11P
TYPE OF GROUP
Leisure Incentive Family Reunion Other Reunion Wedding Other

WHAT CITY/AIRPORT ARE YOU DEPARTING FROM?

LIST ANY OTHERS

WHAT CITY/AIRPORT ARE YOU GOING TO?

NUMBER OF ADULTS IN YOUR GROUP

NUMBER OF CHILDREN IN YOUR GROUP

WHAT ARE THE AGES OF THE CHILDREN?

INTERESTED IN A PACKAGE?
(usually air/hotel/transfers)

ALL INCLUSIVE PACKAGE?
(all inclusive usually means ALL your meals, snacks, drinks, domestic
alcoholic beverages, gratuities, on-site amenities, much more!)

OR, WE CAN DO LAND (HOTEL) ONLY

HOW MANY PEOPLE TO A ROOM?
(2, 3 or 4?)

YOUR EMAIL ADDRESS
(most important!)

YOUR NAME

HOME PHONE NUMBER

BUSINESS PHONE (if convenient)

WHAT IS YOUR PER PERSON BUDGET?
(Per Person)
$500 $600-$800 $800-$1000 $1000-$1200 $1200-$1400 $1400-$1600 $1600-$1800 $1800-$2000 High roller!
HOW DID YOU HEAR ABOUT US?
Search Engine Email Newsletter Other Web Site Internet Yellow Pages Phone Book Friend Booked With Us Before Other
ADDITIONAL COMMENTS?

THAT'S IT! PRETTY PAINLESS, HUH?  NOW HIT THE SUBMIT BUTTON ONCE, 
AND WE WILL GET BACK TO YOU ASAP.
THANKS FOR YOUR REQUEST!!
Did you remember to send us YOUR Email Address?