BOOKING REQUEST FORM (for travel or cruise agents only)
Travel Agency Name*
Agency Phone #*
Agent Direct line or Ext #
IATA/CLIA/TIDS #*
Agent Name*
Agent E-mail*
Booking Information:
Cruise N Stay Package
Ship
Departure Date
Departure City
If other, please specify
Hotel Choice & Deviations (if any)
Cabin Category
Price requested (before tax)
Cabin request
Cabin assignment requests
Cabin upgrades accepted?
Dining requests
Table size
Bedding requests
Cross reference (ie: SMITH)
Special occasions (if any)
Any other booking requests
Past passenger #s (if any)
Passenger Information:
Passenger #1 (MUST MATCH VALID PASSPORT):
First Name #1*
Middle Name(s) #1
Last Name #1*
Birthdate (MANDATORY)
Gender (MANDATORY)
Passenger Information:
Passenger #2 (MUST MATCH VALID PASSPORT):
First Name #2
Middle Name(s) #2
Last Name #2
Birthdate #2 (MANDATORY)
Gender (MANDATORY)
Passenger Information:
Passenger #3 (MUST MATCH VALID PASSPORT):
First Name #3
Middle Name(s) #3
Last Name #3
Birthdate #3 (MANDATORY)
Gender (MANDATORY)
Passenger Information:
Passenger #4 (MUST MATCH VALID PASSPORT):
First Name #4
Middle Name(s) #4
Last Name #4
Birthdate #4 (MANDATORY)
Gender (MANDATORY)
Payment Information: Pre-Registrations - Leave blank
Amount $ (Deposit = $250 CAD pp, except cruises over 5 days & deviations)
Type of payment
Cheque/WRA #
Credit Card #
Expiry date (ie: MM/YY)
Name (as it appears) on card
If you using 2 payments fill here:
Amount $ #2
Type of payment #2
Cheque/WRA #2
Credit Card #2
Expiry date (ie: MM/YY) #2
Name (as it appears) on card #2

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