Client Profile Application

Simply Semper Travels, LLC

Your Personal Travel Concierge
Date

Month Day Year
Date
Name - As printed on your legal identification *

Prefix First Name Middle Name Last Name Suffix
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Phone Number - Home

Area Code Phone Number
Phone Number - Cell *

Area Code Phone Number
Do you have a passport?

Yes No
If YES Passport expiration date.
Are you interested in information in regards to a passport?

Yes No
Air Travel
Flight information

Round Trip One Way
Do you have a Airline Preference?
Airline Rewards - List with # and Airline name
Air Seating Preference

Aisle Window Other
Any Special Accommodations?

Yes, please list below. No
Hotel
Do you have a Hotel Preference?
Hotel Rewards - List with # and Name of Hotel
Hotel Room Preference

Non-Smoking Double - Beds King Bed Roll- Away
Please list number of each room you will need.
Car Rental
Do you have a Rental Agency Preference
Rental Care Rewards - List with # and Agency Name
Car Preference

Economy Compact Mid-Size Full- Size
Do you have any other membership that will allow you an extra discount? List here please.
Booking Information
Departure Date

Month Day Year
Date
Return Date

Month Day Year
Date
Estimate Budget: per person
What are we booking?

Hotel Flight Cruise Tour Entertainment tickets Car Rental
All Inclusive

Yes No
Departure Airport
Arrival Airport
Do you want travel Insurance

Yes No
Cruising Information
Would this be your first cruise?

Yes No
Preferred Port
Cabin Type

Inside Cabin Ocean-view Cabin Mini-Suites Suites
Please list cabin type and number of each cabin.
Preferred Cruise Line
Have you cruised with this cruise line before?

Yes No
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

Prefix First Name Middle Name Last Name Suffix
Date of Birth

Month Day Year
Name

Prefix First Name Middle Name Last Name Suffix
Date of Birth

Month Day Year
Name

Prefix First Name Middle Name Last Name Suffix
Date of Birth

Month Day Year
Name

Prefix First Name Middle Name Last Name Suffix
Date of Birth

Month Day Year
Name

Prefix First Name Middle Name Last Name Suffix
Date of Birth

Month Day Year
Total # of Adults 18 or older on date of travel
Total # of Children
Will you be traveling with Pets?

Yes No
Additional Travelers
Will you need Transport?

Yes No
Any Travelers with military background?

Yes No
Any Travelers affiliated with organization that will provide a special discount? Please list.
Please take the time to "Like" our Facebook page
Thank you so much for taking the time to complete our intake form. Once you click the submit button you will be taking to a form to complete your payment for your security deposit. This deposit will be refunded back regardless if you choose not to book with Simply Semper Travels.

Once again Thank You.
Consultation Deposit *

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USD Consultation security deposit is for research and consulting services. You will get it back regardless if you book or if we are unable to find anything you still get your deposit back.
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Simply Semper Travels, LLC

Air Travel

Hotel

Car Rental

Booking Information

Cruising Information

Travelers Information