Client Profile Application

Simply Semper Travels, LLC

Your Personal Travel Concierge
Date

MonthDayYear
Date
Name - As printed on your legal identification

PrefixFirst NameMiddle NameLast NameSuffix
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number - Home

Area CodePhone Number
Phone Number - Cell

Area CodePhone Number
Do you have a passport?
If YES Passport expiration date.
Are you interested in information in regards to a passport?
Air Travel
Flight information
Do you have a Airline Preference?
Airline Rewards - List with # and Airline name
Air Seating Preference
Any Special Accommodations?
Hotel
Do you have a Hotel Preference?
Hotel Rewards - List with # and Name of Hotel
Hotel Room Preference

Other
Please list number of room(s) you will need.
Car Rental
Do you have a Rental Agency Preference
Rental Care Rewards - List with # and Agency Name
Car Preference
Do you have any other membership that will allow you an extra discount? List here please.
Booking Information
Departure Date

MonthDayYear
Date
Return Date

MonthDayYear
Date
Estimate Budget: per person
What are we booking?

Other
Cruising Information
Departure Airport
All Inclusive
Arrival Airport
Do you want travel Insurance
Would this be your first cruise?
Preferred Port
Cabin Type
Please list cabin type and number of each cabin.
Preferred Cruise Line
Have you cruised with this cruise line before?
Rewards Points
Any Special Accommodations
Travelers Information

This section needs to be completed for every traveler (Adult and Children) Please make sure you complete all the boxes to eliminate any details before our discovery call.
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Total # of Adults 18 or older on date of travel
Total # of Children
Will you be traveling with Pets?
Additional Travelers
Will you need Transport?
Any Travelers with military background?
Any Travelers affiliated with organization that will provide a special discount? Please list.
Thank you for taking the time to complete our intake form. Upon submitting, you will be directed to complete the payment for your non-refundable deposit. This deposit covers the research and planning process, as previously discussed and agreed upon during our discovery call.

Once again Thank You,

Simply Semper Travels
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Research and Planning Consultation Deposit

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USD* Consultation Deposit for Research, Consulting, and Planning Services. This deposit is non-refundable.
Should be Empty:

Simply Semper Travels, LLC

Air Travel

Hotel

Car Rental

Booking Information

Cruising Information

Travelers Information

Research and Planning Consultation Deposit *

Research and Planning Consultation Deposit