Your Contact Information
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First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
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Phone
(###)
###
####
Please note the type of phone number listed above
Cell
Home (landline)
Office (landline)
Can you tell me your desired destination(s)?
Do you know which cruise lines you might be interested in?
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AmaWaterways (river cruising in Europe, Africa, Asia, South America)
American Cruise Lines (river cruising in the U.S.)
American Queen Voyages (river and lakes cruising)
Avalon Waterways (river cruising in Europe, China, Southeast Asia, South America, India, Galápagos Islands)
Cunard Line
Disney Cruise Line
Emerald Cruises (luxury river cruising)
Holland America Line
Norwegian Cruise Line
Oceania Cruises (10-, 14-, and up to 195-day journeys)
Paul Gauguin Cruises (luxury ship cruising Tahiti, French Polynesia and the South Pacific)
Ponant Cruises (French cruising)
Princess Cruises
Regent Seven Seas Cruises
Royal Caribbean Cruises
Star Clipper Cruises (luxury four masted barquentine cruises)
Viking Oceans (ocean and expedition cruises)
Viking River Cruises (European river cruises)
Virgin Voyages (adults only cruising)
Windstar Cruises (luxury small ship cruises)
Is this your first time booking a cruise vacation?
Yes
No, I've cruised before.
Desired Departure Date
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MM
DD
YYYY
Desired Return Date
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MM
DD
YYYY
Are your travel dates firm or flexible?
My travel dates are firm.
My travel dates are very flexible.
My travel dates are flexible within a day or two.
Do you have a passport that expires at least six (6) months after your desired return date?
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Yes
No, but I plan to apply/renew in the next 6 weeks.
Do you plan to book your travel in the next two weeks?
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Yes, I plan to book my travel in the next two weeks.
No, I am only looking for general pricing ideas at this time.
Number of children age 17 and younger at the time of travel:
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Please enter the ages of children who will be traveling:
Will any members of your party require special accommodations for a disability?
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Yes
No
Would you like to include travel protection for this quote?
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Yes, please send me information on Travel Protection.
No, I am declining Travel Protection for this trip.
If you would like to provide additional notes, comments, or information regarding your vacation, please enter them here:
Would you like to be added to my weekly newsletter? (No fear: I have a "no spam" promise!)
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Yes, please!
No, thank you.