Wufoo

VOUCHER INFORMATION
Voucher Code *
What Website Did You Purchase Your Voucher From?

Please enter the name of the company you purchased your voucher from, if you don't remember that's okay too.
Offer/Destination *

Voucher # must match the travel destination in offer purchased.
Preferred Hotel *

Please enter the hotel name listed on your voucher, if multiple hotels are given please let us know which one you prefer. If your voucher does not mention specific hotels please enter none.
Gift Choice *

Many vouchers offer several gift choices such as tickets, a 3rd night etc. Please enter your preference here. If your voucher does not have any of those options please enter none.
TRAVELER CONTACT INFORMATION
Traveler's Full Name * First Last
Please enter you full name as it appears on your identification.
Traveler's Age *

Please input the traveler's age in numbers only (example: 21 for age 21)
Spouse/Partner full name
(required for married or cohabitating couples) First Last
Please enter your spouse or partner full name as it appears on ID.
Spouse's Age (required for married or cohabitating couples)

Please input the spouse's age in numbers only (example: 21 for age 21)
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please list the address associated with your credit card
Email Address *

Please enter your complete e-mail address.
Primary Phone Number * ### - ### - ####
Please list number where you prefer to be contacted.
Alternate Phone Number ### - ### - ####
Preferred Method of Contact *
RESERVATION REQUEST DETAILS
# of Adults Traveling *

Please select the # of adults traveling under this voucher. Your voucher is valid for a specific # of people (please refer to the terms & conditions), additional charges may apply if you have additional guests traveling and is based upon availability.
# of Children Traveling *

Please select the number of children traveling under this voucher. Your voucher is valid for a specific # of people (please refer to the terms & conditions), additional charges may apply if you have additional guests traveling and is based upon availability.
Desired Check-In Date * MM / DD / YYYY
Please select your desired check-in Date. Please do not select any black out dates as listed on the terms & conditions of your offer.
Desired Check-Out Date * MM / DD / YYYY
Please select your desired check-out date. If you chose an additional night as your gift option please be sure to include that night in your check out date.
# of Nights *

Please enter the total # of nights included with your voucher, if you are choosing an additional night as your gift option please include it in your # of nights.
I would like an agent to contact me to discuss additional nights or room upgrades. *
Comments and/or Special Requests

Please enter anything you would like us to know in this box such as non smoking, ground floor, handicap room etc. Although things of this nature may not be guaranteed we will certainly do our best to accommodate your requests.
VERIFICATION INFORMATION

Because your voucher includes a travel presentation we must verify that you meet the terms and conditions of the offer by asking a few questions.
Current Marital Status *
Annual Household Income (before taxes/in US Dollars) *
Credit Card Number (no dashes or spaces) *
Maximum Allowed: 16 digits. Currently Used: 0 digits.

Visa, Mastercard/Discover are all 16 digits, American Express is 15 digits.
Credit Card Expiration Date
* MM / DD / YYYY
Many credit cards do not have an expiration day, just month and year, please enter 01 for the day if your credit card does not have a day listed.
Credit Card CCV Code *
Enter a number between 0 and 4.

Visa, Mastercard and Discover all have a 3 digit ccv or security code, which is the last 3 digits on the back of your card. American Express has a 4 digit security code listed on the front of your card.
By Checking the box below, I agree that I have read, understand and agree to the terms and conditions associated with the use of this vacation voucher. I also agree that I am aware my credit card will be charged a $50 refundable room guarantee upon confirmation of my reservation. By submitting this form, I acknowledge that I am aware my reservation has not yet been confirmed and I will receive notification via email that my dates are or are not available. If available, I will receive a confirmation letter via email prior to travel. If my dates are unavailable, my card will not be charged the $50 refundable room guarantee deposit and I will be contacted by a Reservation Agent to select alternate travel dates. *
I AGREE
Do Not Fill This Out

Wufoo

VOUCHER INFORMATION

TRAVELER CONTACT INFORMATION

RESERVATION REQUEST DETAILS

VERIFICATION INFORMATION