Tell Us About You

Adult's Names (First and Last)		Favorite Character
	Male Female
	Male Female
	Male Female
	Male Female

Children's Names (First and Last)		Age at time of Travel	Favorite Character
	Male Female	0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
	Male Female	0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
	Male Female	0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
	Male Female	0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Guest Contact Name
How Did You Hear about Fairytale Dreams & Destinations?
Friend / Family Invidiata Magazine Vancouver Courier Caledon Enterprise Google/Internet Search Other		Please specify:
Did you want a response from a specific Disney Specialist? If so; please indicate which Vacation Specialist to make certain that they will be the one who will contact you regarding your inquiry
Christine (Teena) Fiorelli Karly Casha Dal Bostrom Robb Pollioni Kathryn Dickson No Preference
Guest Contact Phone
123-123-1234
Guest Contact E-mail Address			Please Verify Contact E-mail Address
Preferred Method of Contact			Do You Require Travel Insurance?
No Preference Telephone E-mail			Yes, Classic Medical Yes, Cancellation & Interruption Yes, Deluxe Insurance Other No Thank You

Dates of Travel

Arrival   Departure

Have I been to Disneyland before?	Select Yes No Not Since I Was A Child
At which Disneyland resort would you like to stay?
Traveling with five in your party? (Children under age three in a crib do not count in your party size.) A party of five can fit into one room ONLY at Disney's Paradise Pier Hotel
Your First Choice Disneyland Resort	- Select a Disneyland Resort - --------------------------------------- I don't know, please help us decide! --------------------------------------- Disney's Paradise Pier Hotel Disneyland Hotel Disney's Grand Californian Hotel --------------------------------------- Disneyland Good Neighbour Hotel
Your Second Choice Disneyland Resort	- Select a Disneyland Resort - --------------------------------------- I don't know, please help us decide! --------------------------------------- Disney's Paradise Pier Hotel Disneyland Hotel Disney's Grand Californian Hotel --------------------------------------- Disneyland Good Neighbour Hotel
How Many Rooms	Select 1 2 3 4 5 More Than 5
Disney Theme Park Tickets
How many days of theme park passes do I want to add to my Disneyland  vacation package?	- Select Days - Not Sure, Please Help! Two Day Park Hopper Three Day Park Hopper Bonus Four Day Park Hopper Bonus Five Day Park Hopper Bonus Six Day Park Hopper Bonus Seven Day Park Hopper Bonus Eight Day Park Hopper Bonus
Dining Option	- Select - Not Sure, Please Help! Yes No Please quote with and without dining
Character Meals (check all that apply)
Character Breakfast Disney Princess Lunch Disney Princess Dinner Goofy's Kitchen Dinner
Are you a Disneyland Annual Passholder?	Yes No
How do you plan on getting to Disneyland?	- Select - Not Sure, Please Help! We will be flying We will be driving
Special Requests Please advise us of any special assistance that a member of your travel party may require.
Additional Information Be sure to mention any special occasions you may be celebrating, such as a honeymoon, anniversary or birthday.