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	REQUEST TOUR OPERATOR REFERRAL
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REQUEST TOUR OPERATOR REFERRAL

Here is your opportunity to express your preferences and priorities for your cruise. Upon receiving your submission, we will reply to you promptly with a personalized referral suited to your needs.

First name
Last name
Street address
City
State / Province	or enter
Zip code
Country
Email
Telephone

I am interested in a river cruise in

My expected date of travel is

My desired length of cruise is

My desired length of total trip abroad is

My party consists of

Approximate age of

passenger 1

passenger 2

passenger 3

passenger 4

I am working with travel a agent

Yes No

I have already contacted a tour operator

Yes No

If yes, which tour operator(s)

I want to augment my cruise with additional excursions

Yes No Not sure

If yes, please specify

I want the cruise to be part of a larger tour through the region

Yes No Not sure

I want the tour operator to provide airfare

Yes No Not sure

My priorities for a cruise are…

priority 1

priority 2

priority 3

priority 4

priority 5

priority 6

My financial approach to this cruise is

I prefer the passengers on my ship to be

My preference for onboard cuisine is

When I fly, I usually fly

For this trip, I most likely will fly

When I stay at a hotel, I usually stay at

On the cruise, I likely will want cabin type

I am interested in a theme cruise

Yes No Not sure

If yes, what kind?

I require handicap facilities on board

Yes No

There are smokers in my party

Yes No

METHOD OF CONTACT:

Please contact me directly with a tour operator referral

Yes No

Please have the recommended tour operator contact me directly

Yes No

Other remarks

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