Trip Planning Form | E. Clarke Travel

First Name*

Last Name*

Preferred Name

Email*

Phone Number*

Where would you like to go?

When would you like to depart?

When would you like to return?

Are your dates flexible?

Yes

No

What is your departure city/preferred starting airport?

How many people will be traveling?

Is this vacation to celebrate anything special?

At what phase of planning are you in?

What is your hotel/resort budget for all travelers? This just gives us a general starting point and can always be adjusted later. (Please note this does not include airfare)*

Other amount (specify amount)

Will you be booking any portion of your trip with points? If so, which pieces?

What travel components would you like us to assist you with? Check all that apply.

What best describes your desired accommodation style?

What are your amenity must-haves?

What options best describe your travel priorities?

Describe your vision for your ideal vacation.

Is there anything else you “must do” or see?

Please describe your ideal itinerary pace (i.e. how many destinations, how scheduled you would like your days, etc.)

Who will be traveling with you? Please list full names (including middle) and birthdates, as listed on the passport.*

Do any travelers have allergies that we should be aware of?

Travel Protection

By making an insurance selection below, I understand that declining insurance would result in the loss of my travel cost and/or require more money to correct the situation.

I also acknowledge that without insurance, there may be no way to recoup losses, costs, expenses incurred, or make any changes, or reschedule.

E. Clarke Travel or any of its affiliates will not be held liable due to my decision to decline travel protection for me or any other individuals traveling in my party.

Accept/Decline Travel Protection

Who can we thank for referring you to us?

Would you like to be subscribed to our newsletter and travel updates?

Yes