Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Have you worked with Unique Romance & Adventure Travel before? * Yes No How did you hear about us? What travel components would you like us to assist you with? Check all that apply. Flights Accomodations Transportation (Car rental, trains, etc.) Excursions & Tours Insurance Preferred date of departure. MM DD YYYY Preferred date of return. MM DD YYYY Are your dates flexible? * Yes No Departure Airport Destination How many adults will be on the trip? How many children will be on the trip? Is there a special occasion associated with your trip? Do you already have a hotel, resort, or cruise picked out? If so, please provide details. If you require assistance finding accommodations, what best describes your desired style? All-inclusive Beach location Relaxing Romance Luxury Party/Celebration Family-Friendly Food & Wine Adventurous Local Culture Does anyone in your group require special accommodations? (Handicap access; food allergies; etc. We want to make sure you're taken care of!) What are you comfortable spending on your trip? $ Please list any special requests or must-haves that will help us plan the perfect trip for you. (ex: great beach, swim-up bar, great pool, adults-only or family friendly resort, all-inclusive resort, activities on property, etc.) If you plan to travel internationally, do you have a passport that will be valid for 6 months after your anticipated travel dates? * * Yes No, but I'm waiting for my new passport to arrive No, but I plan to renew it in time for my trip No, I don't have a passport I am not traveling internationally Please include the full name and birthdates of each traveler in your group. If you plan to travel internationally, this information must match your passports exactly. If you're staying within the States, list the information on your government issued ID. * Based on your needs, what planning service will you require? (Don't worry — Consultations are complimentary) Select all that apply. * Simple Planning $100.00 - Hotel, Air, ready to deposit Full Service $200.00 - Perfect for Mexico and the Caribbean Everything Possible $300.00 - Plane, Trains, Automobiles, hotels/resorts with the best Life Experiences I understand the above planning fees are non-refundable. * Yes, I understand and agree. Would you like to be included on our email list and receive special offers? Yes, please! No, thanks. By clicking below, you consent to have Unique Romance & Adventure Travel collect my details via this form and understand that the information provided is solely for the purpose of travel planning and will not be shared with a third-party. * I agree. Thank you! Client Information Form
