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*Last Name:
*Address:
*City:
*State:		*Zip:
*E-mail Address:
*Phone Number:

Please tell us how you found our website:
Return user/past passenger		AAFP	NARFE
Referral		MOAA	Travelzoo
Google (or other search engine)		AFSA	Other

Are you Active, Retired or Dependent Military? (If Yes, you are eligible for special reduced rates).	Yes No
If you have a preferred consultant, please enter their name:
Departure Date:
Destination:

Number of people traveling:
	Adults		Children

Number of rooms or cabins:

	I want a Cruise		I want a Land Tour
Cruise Line Preference		Tour Operator Preference

Ship Preference
	Inside
	Oceanview
	Balcony
	Suite

Include Air Fare
	Yes		No

Air Gateway:
I am flexible on departure date if a better deal is available.
	Yes		No

Comments and Special Requests: