Tours/Excursions Questionnaire

1 Lead Traveler Information

2 Desired Travel Information

3 Passenger(s) Information

Today's Date*
Date Format: MM slash DD slash YYYY
How did you hear about Time to Split?
Full Name*
First Last
Email
Main Phone Number*
Preferred Method of Communication*
- Email
- Phone Call
- Text
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Number of Seniors (55+)*
Number of Adults (Age 18-54)*
Number of Youths (Under 17 years)*
Special Circumstances I need to consider...*
- Mobility Issues need to be considered
- Special Dietary requirements to be considered
- Someone in the group is Active Military, Retired Military, Fire, EMS or Police
- Someone in the group is pregnant
- None of the above

Maximum Tours & Excursions Budget is...*
Already Booked? Where are you going?*
Multiple Destinations? Upload Day-to-Day Itinerary:
Dates of Travel*
Describe Your Ideal Vacation*
Please explain activities your group enjoys while traveling:
Additional Information:*
Share any special accommodations I need to know about the people attending the trip.

Travelers' Information
First Name Middle Name Last Name DOB

Please add a line for each traveler in your group, exactly written on their passport or government ID.

First Name	Middle Name	Last Name	DOB