EmailMe Form - River Cruise

Thanks for completing this form so that we may provide one free quote for your river cruise. Please contact us with your questions.
Travel With Serenity LLC
Stockbridge, GA
glenda@travelwithserenity.net or (770) 685-4398
Registered & Licensed in the State of Georgia
Henry County Chamber of Commere, Member
ASTA (Association of Travel Advisors), Member
Current Date *
MM / DD / YYYY
Name PAX No. 1 *
First Middle Last
Date of Birth *
MM / DD / YYYY
Cell Phone *
### - ### - ####
Email *
City & State of Residence
Prior River Cruise Client? *
Yes
No
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
PAX No. 2, list all applicable info
Name PAX No. 2
First Middle Last
Date of Birth PAX No. 2
MM / DD / YYYY
Cell Phone PAX No. 2
### - ### - ####
Email PAX No. 2
City & State of Residence
Prior River Cruise Client?
Yes
No
Address PAX No. 2 if different

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Cruise Specifics
Prior Cruise Experience *
Ocean Cruise
River Cruise
Both, Ocean & River Cruise
Bed Configuration *
One Large Bed
Two Twin Beds
Stateroom Desired *
Window
Balcony
Suite
River Cruise Destination Preferred *
Europe
Asia
Egypt
Africa
South America
USA - Mississippi
USA - New England
USA - Pacific NW & Alaska
USA - Southeast
Preferred Activities -- Check all that apply.
The River Cruise Experience
Historical Sites
Concierge Golf Program
Beer Tasting
Food Tasting
Biking
Garden & Nature Tours
Hiking
Museums & Art Galleries
Shopping
Theatre, Ballet & Opera
Wine Tasting, Wineries & Vineyards
Castles & Villages Tours
Renew Wedding Vowels
Purpose of River Cruise
Anniversary
Birthday
Honeymoon
Retirement
Vacation
Vow Renewal
Group Travel
Incentive Travel
Other (List in Comments)
If other, please list below.
Preferred River Cruise Line
Departure Date *
MM / DD / YYYY
Return Date *
MM / DD / YYYY
Services Requested - Double Occupancy *
Window Suite -- cruise, taxes and port charges
Balcony Suite -- cruise, taxes and port charges
Deposit
Gratuities info
Travel Protection Info/Link
Add-on: Shuttle Transfers as applicable
Add-on: Hotel pre-stay offered by river cruise supplier
Add-on: Hotel post-stay offered by river cruise supplier
Flights *
I/We will book our flights.
Add-on: Flight itinerary assistance requested (A Plan-to-Go Small supplement will apply)
Maximum Price Per Person *
$ Dollars . Cents
Group/Organization, if Applicable
How many staterooms needed *
Double occupancy only.
How many adults anticipated? *
How many children anticipated? *
List age(s) at time of travel in comments below.
Is this your first international trip? *
Yes
No
Are you ready to book your river cruise? *
Yes
No
How did you hear about Travel With Serenity? *
Facebook
Family or Friend
Prior Client
Internet
Website
Instagram
LinkedIn
Showcase, Expo, Exhibit
Quote Retainer Statement
The "first river cruise only quote" is free. A minimum non-refundable Quote Retainer of $50.00 is required for additional quotes, flight itinerary, research, or add-on(s) will be billed in advance. Pricing and availability is subject to change without prior notice per the supplier.
This does not apply to the Travel Retainer once booked or applicable supplier fees.
Quote Retainer Acknowledgment *
Yes, I have read the Quote Retainer Statement and will comply as requested.
Other comments, concerns, inquiries or special needs or requests.

PAX No. 2, list all applicable info

Cruise Specifics