April Green's Destination Proposal Request Form

LEAD GUEST: Legal First Name *

LEAD GUEST: Legal Last Name *

Email Address *

Phone Number *

What city & state do you live in? *

How did you hear about us? *

Name, GENDER, and BIRTHDAY of each Guest - PLEASE PROVIDE ALL INFO FOR EACH TRAVELER - WE CAN NOT process your proposal request without the information we are requesting.

NOTE: IF REQUESTING MULTIPLE ROOMS, PLEASE SEPARATE GUESTS BY WHO GOES INTO WHAT ROOM.

For instance:
Room 1: John Allan Smith 12/12/1980 Lisa Elizabeth Smith 10/15/1980 Anna Elizabeth Smith 2/23/2010

Room 2: Greg Michael Paulk 10/23/1979 Angela June Paulk 03/24/1979 Matthew William Paulk 5/15/2014

Guest List *

Choose your Vacation Destination from the list below. *

Is there a price point you would like to stay within? *

Is your price point total or per person? *

Total

Per Person

Travel Dates *

Are your dates flexible? *

Yes

Are you celebrating anything special? *

Do you have a resort or destination in mind? If so, please list those resorts/destinations. If not, please tell us what you'd like to experience at your ideal resort. *

Do you have a preferred cruise line? If so, what is it? If not, please tell us what you'd like in the perfect cruise. *

Do you have a preference in the type of cabin? (Ex: Ocean view, Balcony, Suite, etc.) If not, please put "n/a." *

Is there a specific Disney Cruise Line ship you would like to sail? If so, please list it. If not, please put "n/a." *

Do you have a preference in the type of cabin? (Ex: Ocean view, Balcony, Suite, etc.) If not, please put "n/a." *

How many days in the park do you prefer? *

Would you like Park Hopper (Disney) or Park-to-Park (Universal) tickets? *

If you chose Disney, Disney World provides a Disability Access Service (DAS) for guests who have difficulty tolerating extended waits in a conventional queue environment due to disability. Do you think you may qualify for this service?

Yes

If you chose Disney, some of the resorts use the Disney Skyliner for transportation to Hollywood Studios and Epcot. Is anyone in your party afraid of heights and prefers not to use this mode of transportation? *

Yes, someone in our party is afraid of heights.

No, no one in our party is afraid of heights.

Are you interested in paying for your vacation using Uplift (pay over time in bite-sized payments, based upon approval)? *

Yes

How many park days do you prefer? *

How many parks days do you prefer? *

Which destination would you like to visit? *

What sort of experience are you looking for? *

Independent Land Tour

Escorted Tour

Ocean Cruise

River Cruise

Please list any specific destinations or points of interest you wish to visit. *

What sort of experience are you looking for? *

Safari Experience (escorted or independent)

Independent Land Tour

Escorted Tour

Are there specific locations or destinations you wish to visit? *

What sort of experience are you looking for? *

Independent Land Tour

Escorted Tour

Cruise Experience

Please list any specific destinations or points of interest you wish to visit. *

Please give us all the details on what you would like to experience on your vacation. *

Your entry will be sent to your Travel Advisor.

They will be in touch!