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Travelers
No. of Adults	No. of Seniors	No. of College age
No. of Teens	No.of children under age 12 at time of departure:
	The age of the children are:

Type Of Assistance You Would Like When You Arrive in Cuba?

Would You Like Your Trip to be?


What Type of Vacation You Would Prefer? (please check all that apply)
City stay	Beach stay	Countryside stay
Mountain stay	Colonial Town stay	Small Island stay
Combination city and beach stay	Combination colonial town and beach stay	Combination countryside and beach stay
Combination mountains and beach stay	Combination city and colonial town stay	Combination city and countryside stay
Combination city and mountains stay	Combination colonial town and small island	Combination city and small island stay
Combination countryside and small island stay	Combination mountains and small island stay	Combination mountains and colonial city stay
Active in the city	Relaxing in the city	Day trips to the beach
Day trips to colonial towns	Day Tours to Historical Sites	Day Tours To Ecological Sites
Evening Entertainment	Active in the countryside	Relaxing in the countryside
Active in the mountains	Relaxing in the mountains	Active in and around a Colonial Town
Relaxing in a Colonial Town	Active on a small island	Relaxing on a small island
Day trips to small islands and cays	Relaxing at the beach	Active at the beach
Scuba	Snorkeling	Sailing
Fishing	Boating	Jetskiing
Golf	Tennis	Horseback riding
Cycling	Hiking	Walking by yourself
Guided walking tours	Driving on your own	Driving with a Guide
Sightseeing by tour bus	Sightseeing by local bus	Boat touring on your own
Boat touring with a crew	Day tours by boat	Visit cultural museums
Visit art galleries	See folkloric shows


Where Would You Like To Travel In Cuba?
North Central Cuba
Old Havana how many days?	Eastern Beaches how many days?
Jibacoa how many days?	Varadero how many days?
Matanzas how many days?	Cardenas how many days?
Remedios how many days?	Santa Clara how many days?
Cayo Santa Maria how many days?	Cayo Guillermo how many days?
Cayo Coco how many days?	Ciego De Avila how many days?

Western Cuba
Pinar del Rio how many days?	Vinales how many days?
Soroa how many days?	Las Terrazas how many days?
Maria La Gorda how many days?	Cayo Levisa how many days?
Cayo Largo how many days?	Isla de La Juventud how many days?

Mid Central Cuba
Trinidad how many days?	Cienfuegos how many days?
Sancti Spiritus how many days?

South Central Cuba
Cayo Santa Lucia how many days?	Camaguey how many days?
Las Tunas how many days?

Eastern Cuba
Holguin how many days?	Guardalavaca how many days?
Playa Esmeralda how many days?	Playa Pesquero how many days?
Bayamo how many days?	Guantanamo how many days?
Santiago De Cuba how many days?	Baracoa how many days?


Type of Accommodation You Prefer?


Type of Hotel You Prefer? (please check all that apply)
Full Service Deluxe	Full Service Moderate	Full Service Basic
Historical Elegant	Historical Moderate	Historical Basic
Full Service Beach Resort	Beach Hotel	Beach House
Mountain Hotel	Countryside Hotel	Countryside Cabin
Boat	Camper Motor home	Licensed Casa


Locations You Prefer? (please check all that apply)
Secluded Beach	Island Beach	Resort Beach
Countryside	Mountains	Colonial Town
Major City	Marinas	Campgrounds


Transportation Around Cuba Required? (please check all that apply)
Tour Bus	Local Bus	Airplane
Car Rental	Private Car with Driver and Guide	Taxi
Sailboat	Camper Motor home

Flights Required To Cuba? YES / NO From Where?
Is This Your First Trip To Cuba? YES / NO
IF NO, When and Where in Cuba Did You Visit Before?


Special Requests:

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Destination Info
History & Culture
Events & Festivals
Hotels & Transportation
Educational Program
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Families
Seniors
Water Sports
Weddings & Honeymoons
Incentives & Conferences
VIP Travel