Please use the TAB key between fields. Do not use the "Enter" key.
First name required Last name required Title Company Street address Address (cont.) City State/Province Zip/Postal code Country Work Phone with area code required Home Phone with area code required E-mail required
Required info: Destination for your NEXT CRUISE:
Date of your next cruise:
Length in days of next cruise:
How many people will be cruising?
Is at least one traveler 55+ ? (May qualify for extra discounts)
Yes No
How many cabins (rooms) will be needed?
Preferred cruise line and/or cruise ship (if any):
Did you ever cruise with that cruise line before ? (May qualify for extra discounts)
If you need airfare, please indicate from which airport:
Type of cabin required:
Inside Outside Outside with balcony Suite
Additional comments and requests (this is a "free form" expanding box):
Helpful info:
What is the best time to contact you?
Please select Morning Around noon Early afternoon Late afternoon Early evening Anytime 9 a.m. to 7 p.m.
My 1A Discount Cruises agent is (if you already have one):
I'm a new client I don't remember my agent Not on the list Please assign me an agent Norma Margie Jean Carl Cameron Shannon John Linda
How many times have you cruised before?
Never 1 - 10 times 11 - 20 times More than 20 times
How did you hear about 1A Discount Cruises? Please select I'm a previous client Postcard in the mail Tip from a friend Search Engine AOL MSN Netscape Link from another website Banner ad on other website Email Newspaper or magazine ad Bookmark Just surfing/Cannot remember Other
Would you like to receive email about upcoming promotions or specials?
Yes
No
Click on "submit form" when you are done:
Please submit this form only once. You will see a confirmation page with the submitted information.
Hours: Monday to Friday from 9 am to 5 pm U.S. Eastern time zone
Discount cruises on your favorite cruise lines and cruise ships, including Carnival Cruise Line, Princess Cruises, Royal Caribbean, Celebrity Cruises and more.