Disneyland in California
Room Only Quote Form

How can we contact you?

Title Mr. Mrs. Ms. Miss Master Dr. Rev.

First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip Code:

Country:

Daytime phone number with area code:

Evening phone number with area code:

E-Mail Address:

Confirm
E-Mail Address:

Your Travel Dates

Arrival Date:
(MM/DD/YYYY)

Departure Date:
(MM/DD/YYYY)

Are the Dates Flexible:

YesOONo

If Yes,
enter range of dates:

Travel Party

Number of Adults:

Title

First and Last Name

Title Mr. Mrs. Ms. Miss Master Dr. Rev.

Title Mr. Mrs. Ms. Miss Master Dr. Rev.

Title Mr. Mrs. Ms. Miss Master Dr. Rev.

Title Mr. Mrs. Ms. Miss Master Dr. Rev.

Title Mr. Mrs. Ms. Miss Master Dr. Rev.

Title Mr. Mrs. Ms. Miss Master Dr. Rev.

Number of Children:

Title:

First and Last Name

Age:

Title Miss Master

Title Miss Master

Title Miss Master

Title Miss Master

Title Miss Master

Title Miss Master

Disneyland Resort Accommodations

Preferred Hotel and Room View:

Disney's Grand Californian Hotel Disney's Paradise Pier Hotel Disneyland Hotel
City/Standard View Downtown Disney View Theme Park View City View Concierge Theme Park View Concierge Artisan Suite 1 Bedroom Artisan Suite 2 Bedroom Artisan Suite 3 Bedroom

Second Choice Hotel and Room View:

Disney's Grand Californian Hotel Disney's Paradise Pier Hotel Disneyland Hotel
City/Standard View Downtown Disney View Theme Park View City View Concierge Theme Park View Concierge Artisan Suite 1 Bedroom Artisan Suite 2 Bedroom

If you have a third choice that you would like the travel counselor to search for, please indicate the third choice in the "Additional Comments" box below.

Number Of Rooms:

If you need more than one room, please let us know in comments box below how many adults and children (including children's ages) will be in each room.

As of 03/01/06 all Disneyland Resort Hotels are non-smoking

Information for Possible Discounts

AAA Member? Please enter your AAA membership number and expiration date:

Expiration Date:

Disneyland Annual Pass Holder: If you have a Disneyland annual pass, please enter your annual pass number below.
Note: We cannot quote a Annual Passholder discount without your annual pass number.

Senior Citizen: Is there a member of your party over 60?
No Yes

Additional Information

Travel Counselor: If you have a travel counselor that you would like to work with or are currently working with, please include their name in the box below.
Please assign me a travel counselor Annette Dvorak Arlene Rose Binnie Betten Carla Gesell-Streeter Carol Garcia Carol Gundrum-Darbonne Cindy Langewisch Dean Coleman Deb Chambers Debbie Robertson Emily Williams Erica Colmenares Jeannie Moeller Jennifer Henry Jessica Johnson Johnie Angell Laura Bender LeighAnn Petty Linda Norton Linda Stockwell Lisa McClure Lori Speck Marie Lemmon Marsha Gabauer Mendy Dale Michele Anderson Mike Corbo Mike Rahlmann Missy Davis-Schmit Pam Forrester Ric Flack Robin Frohm Robyn Hughes Rose Mannarino Sarah DeMare Stacy Fultz Stephanie Rouse Steve Baker Steve Forrester Susan Kirby Tina Carlson Tina Krasner Trisha Zavrel

Special Occasions: Please list any special occassions you will be celebrating during your Walt Disney World vacation:

Insurance: Include Insurance in this Quote:
Yes OO No

Optional: How did you find The Magic For Less Travel?
If you were referred to us,
please let us know who referred you so that we can thank them.

Additional Comments