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State of Residence: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Island Virginia Washington West Virginia Wisconsin Wyoming

Country of Residence: United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua/ Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia Botswana Bouvet Island Brazil British West Indies Brunei Darussalam Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Cape Verde Cayman Islands Central Africa Chad Chile China Christmas Island Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador England Equatorial Guinea Eritrea Estonia Ethiopia Europe Common Market Faeroe Islands Falkland Islands Fiji Finland France French Polynesia Gabon Gambia Gaza Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guiana Guinea Guinea-Bissau Guyana Haiti Held Territories Honduras Hong Kong Hungary Iceland India Indian Ocean Islands Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Ireland Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda San Marino Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa South Georgia Spain Sri Lanka St. Helena St. Kitts and Nevis St. Lucia St. Pierre St.Vincent And Grendadines Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu U.S. Minor Outlying Islands Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wales Western Sahara Western Samoa Yemen Yugoslavia Zaire Zambia Zimbabwe Another not listed

Cruise Line Requested: Azamara Cruises Carnival Cruise Lines Celebrity Cruises Cruise West Crystal Cruises Cunard Line Ltd. Holland America Line Oceania Cruises Norwegian Cruises Princess Cruises Regent Seven Seas Royal Caribbean Seabourn Cruise Line Sea Cloud Cruises SeaDream Yacht Club Silversea Cruises Viking River Cruises Windstar Cruises Another Cruise Line

Destination Desired: Alaska - Anywhere Alaska - Gulf of Alaska Alaska - Inside Passage Bahamas Bermuda Canada/New England/NY Caribbean - Anywhere Caribbean - Eastern Caribbean - Southern Caribbean - Western Europe - Anywhere Europe - River Cruise Europe - E. Mediterranean Europe - Mediterranean Europe - Northern Europe - W. Mediterranean Europe - Western Exotic - Asia/Africa/Other Hawaii Mexico Panama Canal/C. America South America South Pacific - Anywhere South Pacific - Australia South Pacific - Tahiti Transatlantic World Cruise Another Destination in Mind

Month to Sail: January February March April May June July August September October November December        Year 2009 2010 2011 2012 2013 2014

Number of Adult Travelers: 1 2 3 4 More than 4 adults We have a Group

# of Children Travelers: None 1 2 3 4 More than 4 children

Type of Stateroom Desired: Owner's Suite Royal Suite Deluxe Suite Demi Suite Mini Suite Outside/Balcony Outside (Superior) Outside (Minimum) Inside (Superior) Inside (Minimum) Guarantee (Inside) Guarantee (Outside) Physically Handicapped Other Type of Cabin in Mind

Length of Cruise Desired: 2 - 3 nights 3 - 5 nights 5 - 7 nights 7 - 10 nights 10 - 14 nights 14 - 21 nights Grand Voyage cruise World Cruise Segments World cruise other

Air or Hotel Required? Yes No Maybe

Desired Budget: $500 - $1,000 $1,000 - $1,500 $1,500 - $2,500 $2,500 - $3,500 $3,500 - $5,000 $5,000 - $10,000 $10,000 - $15,000 Over $15,000 World Cruise pricing

Are you a past passenger? Yes No

If so, which Cruise Line? Azamara Carnival Cruise Lines Celebrity Cruises Cruise West Crystal Cruises Cunard Line Ltd. Holland America Line Oceania Cruises Regent Seven Seas Royal Caribbean Seabourn Cruise Line Sea Cloud Cruises SeaDream Yacht Club Silversea Cruises Viking River Cruises Windstar Cruises Another Cruise Line

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