Name:
Address:
*City State ZipCode:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Phone:
*Email:
*Age:
*Refered to touraine travel by:
Wish to visit:
Africa
Alaska
Asia/Orient
Australia/New Zealand
Britain/Ireland
Caribbean/Bermuda
Europe
Hawaii
Las Vegas
Orlando/Disney
Mediterranean
Mexico
South Pacific
USA/other
Florida
Tahiti/Fiji
Life Cycle:
Single
Married
Family(young)
Family(teens)
Senior 65 plus
College student
31-50
under30
51-65
Trip Type:
Air Only
All-Inclusive
Cruise
Package
Escorted Tour
Group
Independent Tour
Special Interest:
Ecotourism
Active/Adventure
Cruise
Family Fun
Sightseeing
Culinary/wine taste
Gambling
Golf
Beach
Art/Culture/Theater
Skiing
Snorkeling/Scuba-Diving
Spa/Health
Sports
Shopping
Hiking/Walking
Boating/Sailing
Safari
Nightlife/Entertainment
Budget:
Under 1000
1000-2500
2500-5000
5000 +
Desired Length Of Stay:
Quick getaways/weekend
a week
two weeks
over two weeks
Client Source:
Agent personal contact
Corporate Client
Referral
Relative
Tourainetravel.com
Internet survey
yellow Pages
Others:
When we like to travel:
Spring
Summer
Fall
Winter
Christmas/New year
Feb School vacation
April School vacation
Spring break/college
Anytime
Last Minute
How many times in the last year have you booked trvael arrangements online?:
1-3
3-5
5 +
How many times have you booked travel arrangements with travel agents?:
1-3
3-5
5 +
Touraine Travel offers last minute specials and travel information, would you be interested to receive this information via email?
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