First Name *Last Name *Date of Birth *Phone *Email *Please note here if you require any special accommodations for a disability, food allergy, or other needs.0 / 500Street Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweNumber of People to Book *Person 2First Name *Last Name *Relationship *Choose OptionGrandfatherGrandmotherFatherMotherUncleAuntBrotherSisterCousinSonDaughterFriendColleagueDate of Birth *PhoneEmailPlease note here if this traveler requires any special accommodations for a disability, food allergy, or other needs.0 / 500Person 3First Name *Last Name *Relationship *Choose OptionGrandfatherGrandmotherFatherMotherUncleAuntBrotherSisterCousinSonDaughterFriendColleagueDate of Birth *PhoneEmailPlease note here if this traveler requires any special accommodations for a disability, food allergy, or other needs.0 / 500Person 4First Name *Last Name *Relationship *Choose OptionGrandfatherGrandmotherFatherMotherUncleAuntBrotherSisterCousinSonDaughterFriendColleagueDate of Birth *PhoneEmailPlease note here if this traveler requires any special accommodations for a disability, food allergy, or other needs.0 / 500Person 5First Name *Last Name *Relationship *Choose OptionGrandfatherGrandmotherFatherMotherUncleAuntBrotherSisterCousinSonDaughterFriendColleagueDate of Birth *PhoneEmailPlease note here if this traveler requires any special accommodations for a disability, food allergy, or other needs.0 / 500Person 6First Name *Last Name *Relationship *Choose OptionGrandfatherGrandmotherFatherMotherUncleAuntBrotherSisterCousinSonDaughterFriendColleagueDate of Birth *PhoneEmailPlease note here if this traveler requires any special accommodations for a disability, food allergy, or other needs.0 / 500Person 7First Name *Last Name *Relationship *Choose OptionGrandfatherGrandmotherFatherMotherUncleAuntBrotherSisterCousinSonDaughterFriendColleagueDate of Birth *PhoneEmailPlease note here if this traveler requires any special accommodations for a disability, food allergy, or other needs.0 / 500Where do you want to go? *The more descriptive you are, the better.When do you want to go?Earliest Start Date *Latest End Date *How long should the trip be? (Days) *What is your budget for this trip? *USDAmenities and PreferrencesWhat is your preferred airline or alliance? *Input your frequent flyer rewards number here if you have oneFlight Class *Please select an optionEconomyEconomy Premium (If Available)BusinessFirst ClassPay for Seat Choice? *Please select an optionYesNoWhat is your preferred hotel brand? *Include rewards number here if you have oneSelect all the hotel amenities that are important to you for this trip. *Airport ShuttleBarCasinoElectric Car ChargingFree ParkingGym / Fitness CenterGolf CourseHot TubKitchenetteOcean ViewOutdoor SpacePet FriendlyPoolRestaurantRoom ServiceSpaValet ParkingWasher / DryerWifi IncludedEnter your rental car preferences here. *Preferred company, car make and model, heated seats, etc.Enter your tour preferences here. *How do you feel about walking tours? Food tours? Boats, trucks, buses?Choose what is most important to you so we can prioritize the right things when comparing options for your bookings.Select your Highest Priority *Please select an optionArriving and leaving at the exact date and time I specifiedStaying on budgetGetting the amenities I specifiedBooking with my preferred companies.Select your 2nd Highest Priority *Please select an optionArriving and leaving at the exact date and time I specifiedStaying on budgetGetting the amenities I specifiedBooking with my preferred companies.Select your 3rd Highest Priority *Please select an optionArriving and leaving at the exact date and time I specifiedStaying on budgetGetting the amenities I specifiedBooking with my preferred companies.In this box please mention anything you want your travel agent to know that was not covered in the rest of the form. *The more descriptive you are, the better.Disclaimers and Terms Please remember that when booking travel, it is not always possible to book everything exactly as we want it. Sometimes one thing has to be sacrificed to accommodate another. Your booking agent will attempt to match as many of the options as possible with the info you have provided, based on the priorities you have selected on this form. Once the itinerary has been made, you will be given one opportunity to review it and discuss with the booking agent any adjustments you would like made, as well as the payment for your booking. Once the booking has been made, you will receive a pdf with the details of your booking confirmation and much more. The vendors policies dictate the final payment dates and how cancellations are handled. To initiate the booking you will be required to fill out a form with your name, contact details, payment card information, and possibly passport information as well. This information is used by Destinate exclusively to mediate the transaction between the client (you) and the vendor and at no point will a payment be made to Destinate from the client. By filling out the form you authorize Destinate to make the purchase for travel on your behalf. (as is the practice of any travel agent operating under a host agency). By selecting "Yes" below your are acknowledging and agreeing to these terms. IMPORTANT: To purchase your travel, your booking agent will need to input the 3 digit security code on the back of the card you have provided for payment. It is illegal for us to store this number digitally therefore your booking agent will need to call you from Destinates phone number, (480-442-4642), to ask you for this code. Destinate uses Google Voice as our secure means of contacting all our clients though encrypted texts and phone calls. It is safe to provide this info to your booking agent over the phone. It is solely the responsibility of the traveler to ensure that he/she has properly prepared for their trip. Please remember to bring any necessary documentation (passport, drivers license, confirmation codes, etc.). Also remember to bring proper clothing, medicines, sun protection, etc. Additionally it is not recommended that the traveler book anything that they are unable to physically or mentally handle. (flights, cruises, strenuous activities) Lastly, please refer to your pdf for any tasks that will need attention after the booking is made. Thank You. I have read the above disclaimers *YesNo (I will book my own travel instead)Send Message
