OUTSIDE AGENT PAGE
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YOUR ONE STOP CRUISE SHOP
CUSTOMER WORKSHEET FORM                                
Agent Name:_________________
Today's Date:___/___/______
Cruise Line:________________
Cruise Ship:________________
Sailing Date:___/___/______
Departure Date:____/___/___
Booking #:_________________
FIRST PASS.
First Name:______________
Last Name:_______________
Address:__________________
City:_____________________
State:____________________
Zip Code:_____________
Phone #:(_____)___-______
Cell Phone #:(_____)___-____
Business #:(_____)___-_____
Email Address:_____________
Birth Date:____/____/_____
Citizenship:______________
THIRD PASS.
FIFTH PASS.
First Name:________________
Last Name:_________________
Birth Date:___/___/____
Citizenship:____________
Grp Booking #:__________________
Cabin Cat.:_____________________
Cabin #:________________________
Dining: MAIN__LATE___OPEN____
Table Request:SMALL____LARGE_____
Departure Port:___________________
Gateway Airport:__________________
Special Occ.:____________________
SECOND PASS.        
FOURTH PASS.
RATES - 1st. & 2nd         
Air/Sea Rate:$________
Cruise Only Rate:        $_______
Air Add-on:        $___________
Air Deviation:$________        
Travel Insurance:$________
Land Package:$__________        
Prepaid Gratuities:$_______        
Transfers:$__________        
Port Taxes:$_________        
US Departure Tax:$_______        
Fuel Surcharge:$________        
Misc:$__________        
# of Passengers:        _____
Sub-total:$_____________
RATES - 3rd. - 4th. & 5th.                
PAYMENT INFO        
Deposit Amount:$___________        
Date Paid:___/___/___        
Method of Payment:_____________        
1st. Add. Payment:$___________        
Date Paid:___/___/___        
Method of Payment:_____________        
2nd. Add Payment:$_________        
Date Paid:___/___/___        
Method of Payment:____________        
Final Payment:$___________        
Date Paid:___/___/___        
Method of Payment:_____________        
GRAND TOTAL:$____________________        
3rd. Add Payment:$_____________
Date Paid:____/____/____        
Method of Payment:______________
4th. Add. Payment:$____________        
Date Paid:____/____/____        
Method of Payment:_______________        
5th. Add Payment:$______________
Date Paid:___/____/____        
Method of Payment:______________        
        
Balanced owed:$_________
First Name:______________
Last Name:_______________
Address:__________________
City:_____________________
State:____________________
Zip Code:_____________
Phone #:(_____)___-______
Cell Phone #:(_____)___-____
Business #:(_____)___-_____
Email Address:_____________
Birth Date:____/____/_____
Citizenship:______________
Air/Sea Rate:$________
Cruise Only Rate:        $_______
Air Add-on:        $___________
Air Deviation:$________        
Travel Insurance:$________
Land Package:$__________        
Prepaid Gratuities:$_______        
Transfers:$__________        
Port Taxes:$_________        
US Departure Tax:$_______        
Fuel Surcharge:$________        
Misc:$__________        
# of Passengers:        _____
Sub-total:$_____________
First Name:________________
Last Name:_________________
Birth Date:___/___/____
Citizenship:____________
First Name:________________
Last Name:_________________
Birth Date:___/___/____
Citizenship:____________