QUESTIONNAIRE
Please send us the following information so that we can help you plan your dream trip...
Title
- - -
Dr.
Mr.
Mrs.
Ms.
(Optional)
When would you like to travel?
First Name
Starting:
month
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Last Name
Ending:
month
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Daytime Telephone
(000) 123-4567
How many in your party?
1
2
3
4
5
Is this your first trip to France?
yes
no
What regions would you like to visit? (Please number in order of preference)
ALSACE & LORRAINE
CHAMPAGNE
LANGUEDOC-ROUSSILLON
PARIS
AQUITAINE
DORDOGNE VALLEY
LOIRE VALLEY
PICARDY
BRITTANY
FRENCH ALPS
MIDI-PYRÉNÉES
PROVENCE
BURGUNDY
FRENCH RIVIERA
NORMANDY
RHÔNE VALLEY
Anything else?
(Please be brief)
