EmailMe Form - Travel Questionnaire

Today's Date *

MM / DD / YYYY

Primary Contact Name *

First Last

Primary Contact Email *

Primary Contact Phone *

### - ### - ####

Name of Traveler *

First Last

Date of Birth *

MM/DD/YYYY

Name of Traveler

First Last

Date of Birth

MM/DD/YYYY

Name of Traveler

First Last

Date of Birth

MM/DD/YYYY

Name of Traveler

First Last

Date of Birth

MM/DD/YYYY

If over four (4) travelers list names and ages here:

Do ALL Travelers have valid US Passports that expire at least 6 months after return dates of travel? *

YES

NO

If NO was answered above please list passport expiration dates.

Where do you want to travel? List specific destination(s), countries, or events. If not sure, list general types of travel such as all-inclusive resort, cruise, Europe, etc. *

When do you want to travel?
START DATE

MM / DD / YYYY

When do you want to travel?
RETURN DATE

MM / DD / YYYY

When do you want to travel? If you do not have specific days and dates of travel list your desired amount of days, month and year.

TRAVEL BUDGET INFORMATION

What is your TOTAL TRAVEL BUDGET for all travelers? *

$ Dollars . Cents

Type in number with no commas or decimals.

Does this budget range include airfare? *

Yes

No

If Yes, what class of flight is of interest?

First / Business Class

Premium Economy

Economy

If No, how will you purchase air travel?

My Airline Points

My Airline Credit or Voucher

My Credit Card Points

Other

List your preferred city airport for your departure. *

List your secondary city airport for departure. If applicable.

ADDITIONAL INFORMATION

How do you want to travel? *

Independent Travel with guided tours and time to explore on our own.

Fully Escorted Group Rravel with scheduled group tours and transportation.

No Tours for complete indepence to explore on our own.

Other

How active do you want to be while traveling? *

Very Active. Every day has activity.

Moderately Active. Some days of activity and some days of relaxation.

Rarely Active. Every day has rest and relaxation.

Other

What type of travel is of interest? Choose all that apply. *

Why do you want to travel? Special occasion? Unique life event?

Describe any physical challenges to be considered while researching and planning your travel.

What is the BEST travel experience you've experienced? And why?

What is the WORST travel experience you've experienced? And why?

Additional information important for your travels.

Terra Mare Travel LLC is an independently owned and operated franchise of Dream Vacations, a respected brand and global leader in the travel industry. When you choose Terra Mare Travel, you’ll benefit from Dream Vacations enormous buying power and promotional leverage with its vast network of preferred supplier partners. With Terra Mare Travel, you can be confident that you are getting the best value for your travel budget, with a personal level of service to enhance your travel experience.