First Choice Travel Agency Booking Form

www.FirstChoiceTravelAgent.com
318.787.9283

Personal Information:

Note: Names must be exactly as they are on your birth certificate, drivers license and passport.

Guest One

First Name *

Middle Name

Last Name *

Date of birth (MM/DD/YYYY) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Guest Two

First Name *

Middle Name

Last Name *

Date of birth (MM/DD/YYYY) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

If your cabin occupancy is anything other than double, please call 318.787.9283 to book.

Reservation Information

Please select below if your booking is for a individual reservation or a group reservation. If your group is not shown, please select "group not listed" and type the name of the group you are traveling with in the comment section.

Please select one of the following *

Please select one of the following cabin types *

Name on Card *

Credit Card Type *

Credit Card Number *

Security Code *

Expiration Date (mm/yy) *

Payment Amount (Initial deposit is non-refundable/non transferable) *

Credit Card Billing Address *

Address Line 2

City *

State *

Zip Code *

Recurring payments

Would you like to enroll in recurring payments using the credit/debit card above?

Please select one of the following *

If you would like to enroll in recurring payments, please select frequency of automatic payment

In the space below, please give the amount of each recurring payment and the date(s) of the month the automatic payment will be made .(For example- “$50 on the 4th of each month” or “$25 on the 3rd and 18th of each month”, or “$25 every Friday”) You can cancel recurring payments at any time by contacting us in writing at least 5 days before payment date.

Travel Protecrion/Insurance

First Choice Travel recommends the purchase of a travel/vacation protection plan. When planning a trip/vacation, you never foresee situations that may cause you to cancel/delay your travel. A plan can protect you from possible loss of money due to supplier bankruptcy/default, unexpected trip cancellation/ interruption due to accident, sickness or death, baggage loss, medical expenses and emergency air transportation costs. You should purchase a plan usually within 10 days of paying your initial deposit to maintain maximum coverage.

Please select one of the following *

Sign below to complete booking.

By typing your name below, you acknowlege all of the following:
~ my credit/debit card will be charged for the total amount listed above for the passengers listed above.
~ the initial deposit, travel protection plan and any special event fees are NON-REFUNDABLE.
~ the cancellation policies vary by vendor/suppliers. All changes/cancellations are subject to imposed fees by the suppliers (cruise lines).
~you have been advised to read all terms and conditions of your reservation to see what cancellation or change fees apply. First Choice Travel Agency reserves the right to charge a fee up to $100 per passenger, in addition to any fees charged by the supplier (cruise line) for cancellations and/or changes. Name changes may or may not be allowed and are subject to a fee to the supplier and First Choice Travel Agency.

. * 🛈

Type your complete name above

Use the box below if you have any additional commments/information

Optional Instructions/Questions