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First Name Last Name Second Guest Third Guest Fourth Guest Fifth Guest Children's Ages Child 1 0-23mo 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Child 2 0-23mo 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Child 3 0-23mo 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Child 4 0-23mo 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Address City State Zip Code Country Daytime Phone Evening Phone E-mail Land/Cruise Package Trafalgar London Week French Riviera Tour Hawaii Jan 2012 Italian Dream Tour June 2011 Best of Cornwall & Devon Globus Tour of Italy September 2011 Highlights of Greece Seminar at Sea October 2011 Seminar at Sea March 2012 Spa Vacation Request US Location Mexico, Central America Bermuda Caribbean Australia Austria France Germany Hungary Great Britain Israel Italy Jordan Monaco Spain Sweden Switzerland Date Like to Travel January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 23 24 25 26 27 28 29 30 31   2010 2011 2012   Cruise Line AMA Waterways River Cruises Carnival Celebrity Costa Crystal Cruises Cunard Disney Cruise Line Holland America / Windstar Norwegian Princess Cruises Royal Caribbean International Seabourn Silverseas Cruises Windstar Uniworld Viking River Cruises Itinerary Africa/Safari Alaska Asia/Far East Australia/New Zealand Bahamas 3/4 Bahamas/Universal 3/4 Bahamas/Disney 3/4 Key West/ Mexico Bermuda Cruise to Nowhere Eastern Caribbean Western Caribbean Southern Caribbean Europe European River Cruises Greek Isles/Holy Land Hawaii London Mediterranean Mexican Riviera New England Northern Europe Norwegian Fjords Panama Canal SE Asia South America Tahiti Other Number of days 1 2 3-4 5 7 10 or more Number of passengers Type of cabin on cruise Budget Balcony Deluxe Inside Outside Suite Type of room for tour Single Double Triple Quad Celebrating a special occasion? Yes No If so, tell us about it Anniversary Birthday Divorce Honeymoon/Wedding Job promotion Retirement Will you need airline tickets? Yes No From what city? Atlanta, GA Austin, TX Baltimore, MD Boise, ID Boston, MA Buffalo, NY Charlotte, NC Chicago, IL Cincinnati, OH Cleveland, OH Dallas/Ft. Worth, TX Denver, CO Des Moines, IA Detroit, MI El Paso, TX Hartford, CT Houston, TX Indianapolis, IN Kansas City, MO Las Vegas, NV Los Angeles, CA Memphis, TN Miami, FL Milwaukee, WI Minneapolis/ St. Paul, MN Nashville, TN Newark, NJ New Orleans, LA New York, NY Oakland, CA Orlando, FL Philadelphia, PA Phoenix, AZ Pittsburgh, PA Portland, OR Raleigh- Durham, NC Rochester, NY Sacramento, CA Salt Lake City, UT San Antonio, TX San Diego, CA San Francisco, CA San Jose, CA Seattle/Tacoma, WA St. Louis, MO Tampa/ St. Petersburg, FL Washington, D.C. Other If other, what city? Dining choice Early 6:00 PM Free Style Late 8:00 PM Personal Choice Special Dietary Needs? Yes No If so, tell us What is your age group? 21-30 31-45 55 & over Would you like to extend your vacation with a hotel stay before or after tour/cruise? Yes No Will this be a group? Yes No Is this a family reunion? Yes No Comments? Questions? Call Us, we are ready to book a vacation! Call Us!

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