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
WHAT CITY/AIRPORT ARE YOU DEPARTING FROM?

NUMBER OF PEOPLE TRAVELING

ANY CHILDREN? WHAT ARE THE AGES?

WHICH RESORT WOULD YOU LIKE TO STAY IN?
(1 to 3 choices)
Moon Palace Aventura Spa Palace Cancun Palace Playacar Palace Sun Palace Beach Palace Xpu-Ha Palace Hard Rock Hotel Punta Cana NONE Aventura Spa Palace Moon Palace Cancun Palace Playacar Palace Sun Palace Beach Palace Xpu-Ha Palace Hard Rock Hotel Punta Cana NONE Aventura Spa Palace Moon Palace Cancun Palace Playacar Palace Sun Palace Beach Palace Xpu-Ha Palace Hard Rock Hotel Punta Cana  
HOW MANY PEOPLE TO A ROOM?
(2, 3 or 4?)

WOULD YOU LIKE VACATION DOLLARS or UNLIMITED GOLF?
Vac Dollars Unlimited Golf
YOUR EMAIL ADDRESS
(most important!)

YOUR NAME

HOME PHONE NUMBER

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?

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