Request a Quote from Patricia Mickus

Please fill out at the “required” sections of this form.

The more information you provide, the more prepared Patricia will be when she contacts you.

General Information:

1. First name(Required)

2. Last name(Required)

3. Phone(Required)

4. Email(Required)

5. I am a Florida resident(Required)

Yes

What type of vacation are you looking for? (check all that apply)(Required)

Walt Disney World

Disneyland

Universal Orlando Resorts

Cruises

Caribbean and/or All-Inclusive Resorts

Hawaii & Pacific

Other Location

Please provide us with details of the type of vacation you're looking for:

Number of individuals traveling (age at the time of travel):

Adults (18+)

Youth (10-17)

Children (3-9)

Infants (0-2)

Projected dates of travel:

Check-in date

MM slash DD slash YYYY

Check-out date

MM slash DD slash YYYY

I'm interested in a Walt Disney World vacation:

You are looking for WDW lodging, specials, tickets, etc.

I know exactly what I want

I need guidance selecting what I will need

I would like to stay at this Disney Resort:

I need this number of park days (tickets):

I need this type of Theme Park ticket(s):

Standard Base (one Theme Park per day)

Park Hopper (visit more than one Theme Park per day)

Water Park and Sports (one Theme Park per day, plus visits to other WDW fun)

Park Hopper Plus (visit more than one Theme Park per day, plus visits to other WDW fun)

Other

Let's talk about Disney Resorts. Please select your top 3 factors when choosing a WDW Resort hotel:

Ease of transportation to the theme parks

Dining options at the resort

Water features (single pool, multiple pools, waterslide, hot tubs, etc.)

Size of resort (getting to/from rooms, dining, pool. etc.)

Location near a theme park

Bedding configuration (bed sizes, number of beds, etc., please specify below)

Interior corridors required

Resort theme (please specify below)

Other factors (please specify below)

Other factors when choosing a WDW Resort Hotel

How many days do you plan on spending in the Walt Disney World Theme Parks?

Would you like to visit more than one Theme Park per day?

Yes

Are you interested in a Disney dining plan (starting Jan 9, 2024)?

Yes, I know exactly which dining plan I am interested in

No, please make recommendations for me

>> Select the dining plan you are interested in:

Disney Dining Plan

Quick Service Dining Plan

>> Which best describes how your family will likely dine while on vacation:

We plan to have one sit down meal per day

We plan to have 1-2 sit down meals during the entire vacation (the rest will be Quick Service meals)

There is too much to see and do! We don't want to spend too much time in restaurants...

Would you like to visit a Disney Water Park or play a round of golf while at Walt Disney World?

Yes

Would you like to capture magical moments, and get everyone in the picture with Disney's Memory Maker

Of course!

Not this time

Do you have a Disney PIN code?

Have you received a Disney "Unique PIN Code Offer" for possible discounts?

Yes

Your PIN Code AND your mailing address

We need this information to confirm your "Unique PIN Code Offer." This information will not be shared in any way, for any reason, and will be used only for the purpose of checking your PIN code discounts.

Please let us know which of the following possible discounts you might be eligible for:

Disney Visa

Disney+ subscriber

Disney Annual Pass Holder

Military - Active duty or retired (US Military ID required)

Florida resident discount

I'm interested in a Disneyland vacation:

Let's talk about Disneyland resorts. Please select your top 3 factors when choosing a resort hotel:

Onsite Disneyland resort hotel

Good Neighbor resort hotel

Water features (single pool, multiple pools, waterslide, hot tubs, etc.)

Bedding configuration (bed sizes, number of beds, etc., please specify below)

Interior corridors required

Other factors (please specify below)

Which Disneyland resort hotel(s) are you interested in?

Grand Californian Hotel & Spa

Disneyland Hotel

Paradise Pier Hotel

Other factors when choosing a Disneyland resort hotel

How many days do you plan on spending in Disneyland Theme Parks?

Would you like to visit more than one Disneyland Theme Park per day?

Yes

Please let us know which of the following possible discounts you might be eligible for:

Disney Visa

Disney+ subscriber

Disney Annual Pass Holder

Military - Active duty or retired (US Military ID required)

I'm interested in a Universal Orlando Resort vacation:

Let's talk about Universal Orlando Resorts. Please select your top 3 factors when choosing a hotel:

Skip the lines at participating rides and attractions

Ease of transportation to the theme parks

Dining options at the resort

Water features (single pool, multiple pools, waterslide, hot tubs, etc.)

Bedding configuration (bed sizes, number of beds, etc., please specify below)

Resort theme (please specify below)

Other factors (please specify below)

Other factors when choosing a Universal Orlando Resort Hotel

How many days do you plan on spending in Universal Orlando Resort Theme Parks?

Would you like to visit more than one Theme Park per day?

Yes

NOTE: In order to experience the Hogwarts Express Train in the Wizarding World of Harry Potter, you must answer YES

Would you like to visit visit Volcano Bay Waterpark while at Universal Orlando Resort?

Yes

Would you like to capture magical moments, and get everyone in the picture with Universal's Photo Package?

Of course!

Not this time

Are you interested in a Wizarding World of Harry Potter package?

Yes

Please let us know which of the following possible discounts you might be eligible for:

Universal Annual Pass Holder

Military - Active duty or retired (US Military ID required)

Florida resident

I'm interested in cruises:

Are you looking for information about a specific cruise line?

Disney Cruise Lines

Royal Caribbean

Virgin Voyages (adults only)

Carnival Cruises

Norwegian Cruise Lines

Princess Cruise Lines

River Cruises

Other

Which other cruise lines are you interested in?

What Port would you like to sail from?

Where would you like to cruise to?

Are there any specific ports of call that you would like to see on your itinerary?

What length of cruise are you looking for?

3-5 nights

6-9 nights

10+ nights

What type of stateroom are you looking for?

Inside room

Oceanview (porthole)

Balcony/Veranda

Suite

I'm not sure

I'm interested in Caribbean resorts:

Which destinations are you considering

The Bahamas/Caribbean

Mexico

US Virgin Islands/Puerto Rico

Bermuda

Please list the specific island(s) you would like to visit:

Are you looking for supervised children's activities for your family?

Yes

No preference

Are you looking for an adults only resort? (i.e., no children under 18)

Yes

No preference

Please select your top 3 factors when choosing a Caribbean resort:

All-inclusive resort

Buffet or a-la-carte dining

Large resort, with many activities

Small, intimate resort

Bedding configuration (bed sizes, number of beds, etc.)

Interior corridors required

Ocean view required

Other factors (please specify below)

Other factors when choosing a Caribbean resort:

Please select the top 3 activities/amenities important to you and/or your family:

SCUBA

Watersports (e.g., snorkeling, paddleboards, etc.)

Golf packages

Casino

Kids' Club

Tennis/Pickleball

Spa Treatments

Small/cove beach

Long/walking beach

Other (please specify below)

Other Caribbean resort activities/amenities:

On this Caribbean vacation, you are primarily looking to...

Spend the day at the pool/beach with a cool drink

Fill your day with resort activities

Find activities & adventures off-property

All of the above

I'm interested in a Hawaii/Pacific vacation:

Which destinations are you considering

South Pacific

Hawaii

Please list the specific island(s) you would like to visit:

Do you have an island preference?

O'ahu

Maui

Kauai

Hawaii (The Big Island)

Multi-island trip

Are you looking for supervised children's activities for your family?

Yes

No preference

Are you looking for an adults only resort? (i.e., no children under 18)

Yes

No preference

Please select your top 3 factors when choosing a tropical resort:

Buffet or a-la-carte dining

Large resort, with many activities

Small, intimate resort

Bedding configuration (bed sizes, number of beds, etc., please specify below)

Interior corridors required

Ocean view required

Over-the-water bungalows (South Pacific destinations only)

Other factors (please specify below)

Other factors when choosing a tropical resort:

Please select the top 3 activities/amenities important to you and/or your family:

SCUBA

Watersports (e.g., snorkeling, paddleboards, etc.)

Golf packages

Kids' Club

Tennis/Pickleball

Spa Treatments

Small/cove beach

Long/walking beach

Other (please specify below)

Other tropical resort activities/amenities:

On this tropical vacation, you are primarily looking to...

Spend the day at the pool/beach with a cool drink

Fill your day with resort activities

Find activities & adventures off-property

All of the above

Almost done... just a few questions remain

Would you like vacation insurance with your quote?

How did you find out about our travel services?

OTHER DETAILS... Anything else you feel we should know (e.g., celebrations, special needs, specific requests, or a clarification on one of your selections above)

tel. 571.781.2503 info@simpleluxuriestravel.com