Travel Bucket List

Name*

First Last

Phone

Email*

How would you prefer to be contacted

Call
Text
Email

Best time you can be reached

: HH

MM

What destinations are you interested in (or what countries are on your “bucket list”)?

What interests you about this location(s)?

Preferred airport(s)

Preferred dates of travel

Depart

Time

: HH

MM

Return

Time

: HH

MM

How many people will be travelling with you?

Adults

Please enter a value greater than or equal to 0.

Children

Please enter a value greater than or equal to 0.

Children’s Ages

Have you researched your vacation yet?

Yes
No

What kind of research have you done?

What websites have you used to research?

Are you looking for upscale accommodations or is price the primary factor?

Upscale Accommodations
Price

What is your max budget (the price you will not go above)?

What type of vacation is this?

Family Vacation
Honeymoon
“Ladies”
“Guys”
Couple Getaway
Spa Vacation

Do you mostly go out on you own or do you like guided tours?

Go out on my own
Guided Tours

Are you interested in nightlife?

Yes
No

What type of activities are you interested in during this trip?

Do you (or your travel companions) belong to a Hotel Loyalty Program

Yes
No

Hotel Loyalty Program

Do you (or your travel companions) belong to a Airline Points/Miles Program

Yes
No

Airline Points/Miles Program

Plane seat preference

Aisle
Middle
Window

Are you (or your travel companions) active or retired military, police, firefighters, EMTs or paramedics?

Yes
No

If yes, who and what branch?

AvecPanache is committed to providing you with the best “vakay” possible, so please provide us with any information you think will help us achieve that!