What would be your dream vacation in 2003?

Name Day
Phone
 
Home
Address
Evening
Phone
 
City State Zip   Best Time & Method of Contact:
Email
Destination (if decided)  
Area of Interest  
Country of Interest  
Date of Departure  
Date of Return  

Comments regarding flexibility in travel schedule

 Total number of people traveling in party
 Number of adults  Number of children (17 & under)

 Accommodations:

 Economy

Moderate

 Deluxe

Five Star
What type of car would you prefer:

Sub Compact

Compact

Mid Size

Full Size

4 Door

Luxury
  Won't be needing a car        

INTERESTS & DESTINATION INFORMATION
Interests: Destinations
4-W Drive Expeditions Food Wine Africa
Adult Education Golf Alaska
Adventure/Expeditions Hiking/Backpacking Asia
Archaeology Independent Travel Australia
Art & Theatre Indigenous Cultures Canada
Ballooning Kayak/Canoe/Rafting Caribbean
Barging Naturalist/Eco-Travel Central America
Birding Photo Treks China
Climbing Rail Travel Eastern Europe
Cruises (see also below) Ranches/Lodges Hawaii
Cycling Resorts Mexico
Diving Safari/Wildlife Middle East
Equestrian/Trails Sailing/Boating North America
Escorted Tours Scuba Polar Regions
Expedition Cruising Skiing/Snow Sports Russia
Family Adventures Spas Scandinavia
Family/Disney Sun & Sand South America
Fishing Walking South Pacific
Water Sports USA (Continental)
Western Europe

CRUISES (please check those that you are interested in):

Agressor Fleet   Cunard Lines    Radisson Seven Seas Cruises 
  American Hawaii Cruises    Delta Queen Steamboats    Royal Caribbean International 
  Bilikiki Cruise    Disney Cruise Lines    Royal Olympic Cruise 
  Carnival Cruise Lines    Holland America   Seabourne Cruise Line 
  Celebrity Cruise    Norwegian Cruise Lines    Silversea Cruise 
  Commodore Cruise Lines    Orient Lines   Star Clippers 
  Costa Cruise Lines    Premier Cruise    Windjammer Barefoot Cruises 
  Crown Princess/Regal Princess    Princess Cruise    Windstar Cruise 
  Crystal Cruise       

Please describe any other interests or destinations you would like to have listed:

Would you like to receive a monthly e-mail full of travel tips and specials from Southwest Diver? 
(Your e-mail address would only be used for this purpose and would be kept confidential)

Yes, please send the electronic newsletter to me at the above address (ie. name@domain.com):

What directed you to our website?
Saw our magazine
Friend told me about your site
Read review or news article
Found it through a search engine,  please specify which one: 
I am a current subscriber
Other (please specify): 

ALL INFORMATION IS KEPT CONFIDENTIAL.

*