AotS Fee Request FORM - Autism On The Seas

Request to receive amounts $$:

- Staff Assisted Cruise - Service Fee
- 1:1 Service (additional) Fee

Fee Details (incl 1:1 option)

Select Cruise

Please Select a Cruise

First Name

Please enter your Name

Last Name

Please enter your Name

Your Email

Please provide your email address.

Have you Cruised with us Prior?

Yes, we cruised on a Staff Assisted Cruise

Currently booked on a Staff Assisted Cruise

No

Invalid Input

Aside from PRICE and your family's SCHEDULE, do you have any other reasons standing in your way of booking?

Select one

NO: We are ready to book if price is right

Yes: We still have some concern about cruising with our child with special needs

Other

Invalid Input

Explain here please

Invalid Input

Your Preferred Method for us to Contact you?

EmailPhoneEither is Fine Invalid Input

Phone Number

Please Enter FULL Phone Number