The cruise lines ask for various types of information depending on the situation. Please fill out the following form and click submit. This information is required before I can book your cruise. First Name * This should be exactly as on your Passport or Birth Certificate Middle Name Last Name * This should be exactly as on your Passport or Photo ID Gender * Female Male Date Of Birth * Month - Day - Year Phone Number Where You Receive Most Calls: * Alternate Phone Number (if applicable) Email Address Street Address City - State - Zip Are You A US Citizen? * Yes No Do You Have A US Passport? * Yes No When Does Your Passport Expire? Month and Year (if applicable) Emergency Contact Person's Name This should be a person not traveling with you Emergency Contact Person's Phone Have You Ever Been On A Cruise? Yes No Please Check Any Special Occasion You Will Be Celebrating Birthday Anniversary Honeymoon Graduation Other Please Check Any Items That May Apply To You: Need A Wheelchair Use Insulin Needles Need A Special Diet If Female, Check If Pregnant Use Portable Oxygen Please List Any Questions Or Comments reCAPTCHA 5 Comments susan denmark - March 31, 2015 hi mr Leland received your email really interested in going on cruise Reply to comment→ leland - March 31, 2015 That’s great! Reply to comment→ susan denmark - March 31, 2015 mr Leland I would tried to include other information for other family members should I go back in an include information Reply to comment→ leland - March 31, 2015 Yes – I would need info for each person going. I probably ask for more than the basic info but things like birth date, and contact info are a must. – Thanks! Reply to comment→ Laurie Pettitt - June 11, 2015 Thanks Leland! Really looking forward to our cruise! Laurie & Tim Pettitt Reply to comment→ Leave a reply Cancel reply Name * Email * Website Notify me of new posts by email.