Travel Professionals

Your name: (required)

Agency: (required)

CONTACT DETAILS

Phone: (555-555-1212) (required)

Your email: (required)

May we put your name on our email list?
NoYes

Lead name of client: (required)

Rental date start: (Month, Day, Year)

Rental date end: (Month, Day, Year)

Number of adults:

Number of children:

Ages of children:

Any elderly persons?
NoYes

Number of bedrooms:

Min. number of bathrooms:

Region of interest:

City of interest:

What is the purpose of your client’s vacation?
(Family time together, visiting historical villages, wine tasting etc)

What amenities are essential? (ie. WiFi, Pool, Air Conditioning)

Any other considerations or requests?

Do you have a deposit (intent to book fee) from your client on this Vacation?
NoYes

10 + 5 =

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