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CRUISE QUOTE REQUEST FORM
Please complete this form to provide us with the information we will need to prepare your quote
Contact Information
Name
*
First
Last
Email
*
Phone
*
###
-
###
-
####
Best time to reach me
(Select all that apply)
*
Morning
Afternoon
Evening
Weekdays
Weekends
Any time
Cruise Travel Dates
Departure Date
*
MM
/
DD
/
YYYY
Return Date
*
MM
/
DD
/
YYYY
Are your travel dates flexible
*
Please select
Yes
No
If your dates are flexible, you can select the Month and Year that you want to sail instead of selecting a date range
Month and Year
MM
/
YYYY
Cruise Style Preference
Type of Cruise
*
Please select
Family Cruise
Girlfriends Getaway
Group Cruise
Mancation
Multi-Generational Cruise
Music Themed Cruise
River Cruise
Romantic Cruise
Singles Cruise
Ship Size
Please select
Large - 3,000+ Guests
Mid Sized - 1,000 - 3,000 Guests
Moderate - 700 - 1,000 Guests
Intermediate - 300 - 700 Guests
Small - 300 or less Guests
Interests
Please select
Food and Wine
Golf
Music
Fitness/Health and Wellness
Spa
Cruise Information
Length of Cruise
*
Please select
1 - 2 nights
3 - 4 nights
5 - 6 nights
7 - 10 nights
11 + nights
Departure Port
*
Baltimore, MD
Bayonne, NJ
Ft Lauderdale, FL
Galveston, TX
Honolulu, HI
Los Angeles, CA
Miami, FL
New Orleans, LA
New York, NY
Port Canaveral (Orlando), FL
Seattle, WA
Africa
Asia
Australia
Canada
Caribbean
Europe
Mediterranean
South America
South Pacific
Other (List below)
NOTE: Not all ports will be available for all Cruise Lines
Departure Port
(Other)
Cruise Destination
*
Africa
Alaska
Antarctica
Arctic & Fjords
Asia
Australia
Bahamas
Bermuda
Canada/New England
Caribbean
Europe
Hawaii
Latin America
Mediterranean
Mexico
Pacific and Oceania
Repositioning
Transatlantic
Other (List below)
Cruise Destination
(Other)
Cruise Line
Cruise Line
(First Choice)
*
Please select
Need help making a selection
American Cruise Line*
Avalon Waterways*
Azamara Club Cruises
Carnival Cruise Lines
Celebrity Cruises
Cunard Line
Disney Cruise Lines
Holland America Line
MSC Cruises
Norwegian Cruise Lines
Paul Gauguin Cruises
Ponant**
Princess Cruises
Regent Seven Seas
Royal Caribbean Cruise Lines
Seaborn Cruise Line*
Scenic Cruise Line*
Viking River Cruises*
*Offers River Cruises
**Offers Yacht Cruises
Are you a past guest on this cruise line
*
Please select
Yes
No
Past guest number
Cruise Line
(Second Choice)
Please select
Need help making a selection
American Cruise Line*
Avalon Waterways*
Azamara Club Cruises
Carnival Cruise Lines
Celebrity Cruises
Cunard Line
Disney Cruise Line*
Holland America Line
MSC Cruises
Norwegian Cruise Lines
Paul Gauguin Cruises
Ponant**
Princess Cruises
Regent Seven Seas
Royal Caribbean Cruise Lines
Seaborn Cruise Line*
Scenic Cruise Line*
Viking River Cruises*
*Offers River Cruises
**Offers Yacht Cruises
Are you a past guest on this cruise line
Please select
Yes
No
Past guest number
Stateroom Selection
Please indicate your Stateroom selections below.
If you need more than one cabin, please provide the information for the additional cabin(s) in the Additional Information section below
Stateroom
*
Studio (Single)
Balcony
Inside
Suite
Ocean View
Stateroom Location
(Select all that apply)
*
Low Deck
Middle Deck
Upper Deck
Forward
Mid Ship
Aft
Port
Starboard
Do you need an accessible Stateroom
*
Please select
Yes
No
Select this option if you need a wheelchair accessible stateroom
Stateroom Configuration
Maximum cabin capacity on most cruise ships is 4-5 people
Number of Adults
(ages 18+)
*
Please select
1
2
3
4
Children's age
(17 and under)
*
Child #1
Please select
None
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Child #2
Please select
None
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Child #3
Please select
None
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Child #4
Please select
None
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Provide the age at the time of sailing
Package Components
Airfare
*
Airfare
I do not need airfare
Departure City
(for Airfare)
Travel Insurance
*
Travel Insurance
I do not want Travel Insurance
Travel Insurance is highly recommended
NOTE: Once travel insurance is added, it cannot be removed & is non-refundable
Accessible Needs
*
Wheelchair
Scooter
Oxygen
None
Ground Transportation
*
Cruise Line Transfers
Shuttle Service
Private Transfers
Car Rental
None
Hotels
*
Pre Cruise Hotel
None
Pre Cruise Hotel Check In Date
MM
/
DD
/
YYYY
Pre Cruise Hotel Check Out Date
MM
/
DD
/
YYYY
Hotels
*
Post Cruise Hotel
None
Post Cruise Hotel Check In Date
MM
/
DD
/
YYYY
Post Cruise Hotel Check Out Date
MM
/
DD
/
YYYY
Affiliations
Affiliations
(Select all that apply)
*
AARP
Firefighter
Military - Active
Military - Retired
Police
None
Select the Organization(s) you are affiliated with
Additional Information
Trip Budget
*
Please select
$1,000 - $1,999
$2,000 - $2,499
$2,500 - $3,499
$3,500 - $4,499
$4,500 - $5,499
$5,500 - $6,499
$6,500 - $7,499
$8,000 +
This is your per person budget for each traveler for all components selected
Number of Cruises taken
*
First Cruise
2 - 4 Cruises
5+ Cruises
Time frame to book?
(Select one)
*
Ready to book - Contact me ASAP
Book within 7 - 14 days
Book within two to three weeks
Book within one to three months
Just started planning
Is there anything else we should know?
*Offer Code
*Additional Staterooms
*Special Requests
*Celebrations
*Do you have any questions?
If you will be celebrating a special event during this cruise, provide the date of the event (ex. birth date, wedding date, anniversary date)
How did you hear about Great Escapes Travel?
*
Cinemark Movie Theater
Facebook
Instagram
Internet
Past Client
Referral
Travel Leaders
Other
Please list Referral/Other
Provide the name of the person who referred you or where you heard about Great Escapes Travel, LLC
Would you like to receive special offers via email?
*
Please select
Yes
No
Escape Artist
*
Please select
Angela Barr
Select the Travel Agent you would like to work with
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