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https://www.emailmeform.com/builder/embed/B1r4Qa3cni6a0a
Submission: On May 15 via manual from US — Scanned from DE
Submission: On May 15 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST https://www.emailmeform.com/builder/form/B1r4Qa3cni6a0a
<form id="emf-form" target="_blank" class="topLabel" enctype="multipart/form-data" method="post" action="https://www.emailmeform.com/builder/form/B1r4Qa3cni6a0a">
<div id="emf-form-instruction" class="emf-head-widget">
<div id="emf-form-title" class="emf-bold">Princess Cruises Reservation Form</div>
<div id="emf-form-description">Please fill out a separate form for each passenger.<br>
<br> Any field marked with a red * is a required field to secure your reservation and book your cabin. You may call us at a later date with any of the other information if you do not have it at this time.<br>
<br> PLEASE CALL 1-800-423-0247 FOR WHEELCHAIR/SCOOTER ACCESSIBLE CABIN AVAILABILITY
</div>
</div>
<ul>
<li id="emf-li-0" class="emf-li-field emf-field-Image cell_align_center">
<label class="emf-label-desc" for="element_0"></label>
<div class="emf-div-field"><img id="element_0" name="element_0" src="https://files.emailmeform.com/2040345/Y2f7p0AE/GrandAmerican%20small.jpg" style="width:234px;height:141px;border:0;" title="" alt="" class="validate[optional]"></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-1" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_1">Cruise Destination <span>*</span></label>
<div class="emf-div-field"><input id="element_1" name="element_1" value="" size="30" type="text" class="validate[required]"></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-2" class="emf-li-field emf-field-select data_container ">
<label class="emf-label-desc" for="element_2">Cruise Line <span>*</span></label>
<div class="emf-div-field"><select id="element_2" name="element_2" class="validate[required]" my_choice_order_type="">
<option value="" my_order_property="first">Please select</option>
<option value="Princess" selected="selected">Princess</option>
</select></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-3" class="emf-li-field emf-field-datetime data_container ">
<label class="emf-label-desc" for="element_3">Departure Date <span>*</span></label>
<div class="emf-div-field"><span class="emf-field-datetime-month">
<input maxlength="2" id="element_3_year-mm" name="element_3_month" value="" class="validate[required,custom[onlyNumber],length[2,2],lengthValue[1,12]] emf-input-w20" type="text" size="2">
<label for="element_3_year-mm" class="emf-bottom-label">MM</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-day">
<input maxlength="2" id="element_3_year-dd" name="element_3_day" value="" class="validate[required,custom[onlyNumber],length[2,2],lengthValue[1,31]] emf-input-w20" type="text" size="2">
<label for="element_3_year-dd" class="emf-bottom-label">DD</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-year">
<input maxlength="4" id="element_3_year" name="element_3_year" value="" class="validate[required,custom[onlyNumber],length[4,4]] emf-input-w40" type="text" size="4">
<label for="element_3_year" class="emf-bottom-label">YYYY</label>
</span><span>
<input type="hidden" id="element_3_" class="datepicker hasDatepicker" my_date_format="mm/dd/yy" value=""><img class="ui-datepicker-trigger" src="//assets.emailmeform.com/images/calendar.png" alt="..." title="...">
</span></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-4" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_4">Group Leader's Name or Group Name <span>*</span></label>
<div class="emf-div-field"><input id="element_4" name="element_4" value="" size="50" type="text" class="validate[required]">
<div class="emf-div-instruction">You can enter "not sure" or N/A if you don't have one</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-5" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_5">Would you like a copy of your form emailed to your group leader? <span>*</span></label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_5_0" name="element_5" value="Yes" class="validate[required]" type="radio" onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label
class="padleft-w5" for="element_5_0">Yes</label></div>
<div class="one_column"><input id="element_5_1" name="element_5" value="No" class="validate[required]" type="radio" onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label
class="padleft-w5" for="element_5_1">No</label></div>
</div>
<div class="emf-div-instruction">By selecting Yes, you authorize Grand American Tours to forward a copy of your form to your group leader on your behalf. Passport and cc information will be omitted.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-6" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_6">Name Prefix <span>*</span></label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_6_0" name="element_6" value="Mr" class="validate[required]" type="radio" onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label
class="padleft-w5" for="element_6_0">Mr</label></div>
<div class="one_column"><input id="element_6_1" name="element_6" value="Mrs" class="validate[required]" type="radio" onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label
class="padleft-w5" for="element_6_1">Mrs</label></div>
<div class="one_column"><input id="element_6_2" name="element_6" value="Ms" class="validate[required]" type="radio" onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label
class="padleft-w5" for="element_6_2">Ms</label></div>
</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-7" class="emf-li-field emf-field-new_name data_container ">
<label class="emf-label-desc" for="element_7">Name as it appears on your passport <span>*</span></label>
<div class="emf-div-field"><span style="width:60px">
<input class="validate[required]" style="width:100%" value="" id="element_9" name="element_9" type="text">
<label for="element_9" class="emf-bottom-label emf-text-center">First</label>
</span><span style="width:40px">
<input class="validate[optional]" style="width:100%" value="" id="element_13" name="element_13" type="text">
<label for="element_13" class="emf-bottom-label emf-text-center">Middle</label>
</span><span style="width:100px">
<input class="validate[required]" style="width:100%" value="" id="element_10" name="element_10" type="text">
<label for="element_10" class="emf-bottom-label emf-text-center">Last</label>
</span><span style="width:40px">
<input class="validate[optional]" style="width:100%" value="" id="element_11" name="element_11" type="text">
<label for="element_11" class="emf-bottom-label emf-text-center">Suffix</label>
</span>
<div class="emf-div-instruction">There is a fee to change an incorrect name. If you are renewing your passport, please provide the name on your old passport or the name you plan to use.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-14" class="emf-li-field emf-field-new_address data_container ">
<label class="emf-label-desc" for="element_14">Address <span>*</span></label>
<div class="emf-div-field">
<div style="width:99%;">
<span class="emf-full emf-field-new_address-addr1">
<input type="text" value="" id="element_15" name="element_15" class="emf-full validate[required]">
<label for="element_15" class="emf-bottom-label">Street Address</label>
</span>
<span class="emf-left emf-half emf-field-new_address-city">
<input type="text" value="" id="element_17" name="element_17" class="emf-full validate[required]">
<label for="element_17" class="emf-bottom-label">City</label>
</span>
<span class="emf-right emf-half emf-field-new_address-state">
<input type="text" value="" id="element_18" name="element_18" class="emf-full validate[required]">
<label for="element_18" class="emf-bottom-label">State / Province / Region</label>
</span>
<span class="emf-left emf-half emf-field-new_address-zipcode">
<input type="text" value="" id="element_19" name="element_19" class="emf-full validate[required]">
<label for="element_19" class="emf-bottom-label">Postal / Zip Code</label>
</span>
<div class="emf-clear"></div>
</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-21" class="emf-li-field emf-field-phone data_container ">
<label class="emf-label-desc" for="element_21">Cell Phone</label>
<div class="emf-div-field">
<span>
<input maxlength="3" value="" id="element_21_1" name="element_21[]" type="text" class="emf-input-w30 validate[optional,custom[onlyNumber],length[3,3]]">
<label for="element_21_1" class="emf-bottom-label">###</label>
</span><span class="emf-sep">-</span><span>
<input maxlength="3" value="" id="element_21_2" name="element_21[]" type="text" class="emf-input-w30 validate[optional,custom[onlyNumber],length[3,3]]">
<label for="element_21_2" class="emf-bottom-label">###</label>
</span><span class="emf-sep">-</span><span>
<input maxlength="4" value="" id="element_21_3" name="element_21[]" type="text" class="emf-input-w40 validate[optional,custom[onlyNumber],length[4,4]]">
<label for="element_21_3" class="emf-bottom-label">####</label>
</span>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-22" class="emf-li-field emf-field-phone data_container ">
<label class="emf-label-desc" for="element_22">Home Phone</label>
<div class="emf-div-field">
<span>
<input maxlength="3" value="" id="element_22_1" name="element_22[]" type="text" class="emf-input-w30 validate[optional,custom[onlyNumber],length[3,3]]">
<label for="element_22_1" class="emf-bottom-label">###</label>
</span><span class="emf-sep">-</span><span>
<input maxlength="3" value="" id="element_22_2" name="element_22[]" type="text" class="emf-input-w30 validate[optional,custom[onlyNumber],length[3,3]]">
<label for="element_22_2" class="emf-bottom-label">###</label>
</span><span class="emf-sep">-</span><span>
<input maxlength="4" value="" id="element_22_3" name="element_22[]" type="text" class="emf-input-w40 validate[optional,custom[onlyNumber],length[4,4]]">
<label for="element_22_3" class="emf-bottom-label">####</label>
</span>
<div class="emf-div-instruction">if different from your primary phone</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-23" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_23">Which is your preferred contact number? <span>*</span></label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_23_0" name="element_23" value="Cell Phone" class="validate[required]" type="radio"
onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label class="padleft-w5" for="element_23_0">Cell Phone</label></div>
<div class="one_column"><input id="element_23_1" name="element_23" value="Home Phone" class="validate[required]" type="radio"
onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label class="padleft-w5" for="element_23_1">Home Phone</label></div>
</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-24" class="emf-li-field emf-field-email data_container ">
<label class="emf-label-desc" for="element_24">Email</label>
<div class="emf-div-field"><input id="element_24" name="element_24" class="validate[optional,custom[email]]" value="" size="30" type="text">
<div class="emf-div-instruction">By entering your email address, you will receive an email confirmation of your submission which includes a copy of the completed form. Passport and credit card information will be omitted.</div>
</div>
<div class="emf-clear"></div>
<div class="emf-fake-li-wrapper"><label class="emf-label-desc" for="element_24_confirm">Confirm</label>
<div class="emf-div-field"><input id="element_24_confirm" class="validate[[confirm[element_24]]" value="" size="30" type="text" onpaste="return false;" autocomplete="off"></div>
<div class="emf-clear"></div>
</div>
</li>
<li id="emf-li-25" class="emf-li-field emf-field-datetime data_container ">
<label class="emf-label-desc" for="element_25">Date of birth <span>*</span></label>
<div class="emf-div-field"><span class="emf-field-datetime-month">
<input maxlength="2" id="element_25_year-mm" name="element_25_month" value="" class="validate[required,custom[onlyNumber],length[2,2],lengthValue[1,12]] emf-input-w20" type="text" size="2">
<label for="element_25_year-mm" class="emf-bottom-label">MM</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-day">
<input maxlength="2" id="element_25_year-dd" name="element_25_day" value="" class="validate[required,custom[onlyNumber],length[2,2],lengthValue[1,31]] emf-input-w20" type="text" size="2">
<label for="element_25_year-dd" class="emf-bottom-label">DD</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-year">
<input maxlength="4" id="element_25_year" name="element_25_year" value="" class="validate[required,custom[onlyNumber],length[4,4]] emf-input-w40" type="text" size="4">
<label for="element_25_year" class="emf-bottom-label">YYYY</label>
</span><span>
<input type="hidden" id="element_25_" class="datepicker hasDatepicker" my_date_format="mm/dd/yy" value=""><img class="ui-datepicker-trigger" src="//assets.emailmeform.com/images/calendar.png" alt="..." title="...">
</span></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-26" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_26">Were you born in the United States? <span>*</span></label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_26_0" name="element_26" value="Yes" class="validate[required]" type="radio" onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label
class="padleft-w5" for="element_26_0">Yes</label></div>
<div class="one_column"><input id="element_26_1" name="element_26" value="No" class="validate[required]" type="radio" onchange="toggle_emf_element(EMF_jQuery(this).parents('.emf-li-field').find('.emf-allow-other input'), false)"><label
class="padleft-w5" for="element_26_1">No</label></div>
</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-27" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_27">If no, what country were you born in?</label>
<div class="emf-div-field"><input id="element_27" name="element_27" value="" size="30" type="text" class="validate[optional]"></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-28" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_28">Passport Number</label>
<div class="emf-div-field"><input id="element_28" name="element_28" value="" size="30" type="text" class="validate[optional,length[9,9]]">
<div class="emf-div-instruction">This number can be found in the top right corner of the page with your picture and is 9 digits long. If you are renewing your passport, your number will change so you can leave this blank and call us when you
receive the new information.</div>
</div>
<div class="emf-clear"></div>
<div class="emf-fake-li-wrapper"><label class="emf-label-desc" for="element_28_confirm">Confirm</label>
<div class="emf-div-field"><input id="element_28_confirm" class="validate[[confirm[element_28]]" value="" size="30" type="text" onpaste="return false;" autocomplete="off"></div>
<div class="emf-clear"></div>
</div>
</li>
<li id="emf-li-29" class="emf-li-field emf-field-new_checkbox data_container ">
<label class="emf-label-desc" for="element_29">Passport Issuing Authority</label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_29_0" name="element_29[]" value="United States Department of State" class="validate[optional]" type="checkbox"><label class="padleft-w5" for="element_29_0">United States Department of State</label>
</div>
<div class="one_column"><input id="element_29_1" name="element_29[]" value="Other" class="validate[optional]" type="checkbox"><label class="padleft-w5" for="element_29_1">Other</label></div>
</div>
<div class="emf-div-instruction">You should find this on the same page to the right of the issue and expiration dates.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-30" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_30">If you checked Other, what is your passport's issuing authority?</label>
<div class="emf-div-field"><input id="element_30" name="element_30" value="" size="30" type="text" class="validate[optional]"></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-31" class="emf-li-field emf-field-datetime data_container ">
<label class="emf-label-desc" for="element_31">Date of Issue</label>
<div class="emf-div-field"><span class="emf-field-datetime-month">
<input maxlength="2" id="element_31_year-mm" name="element_31_month" value="" class="validate[optional,custom[onlyNumber],length[2,2],lengthValue[1,12]] emf-input-w20" type="text" size="2">
<label for="element_31_year-mm" class="emf-bottom-label">MM</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-day">
<input maxlength="2" id="element_31_year-dd" name="element_31_day" value="" class="validate[optional,custom[onlyNumber],length[2,2],lengthValue[1,31]] emf-input-w20" type="text" size="2">
<label for="element_31_year-dd" class="emf-bottom-label">DD</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-year">
<input maxlength="4" id="element_31_year" name="element_31_year" value="" class="validate[optional,custom[onlyNumber],length[4,4]] emf-input-w40" type="text" size="4">
<label for="element_31_year" class="emf-bottom-label">YYYY</label>
</span><span>
<input type="hidden" id="element_31_" class="datepicker hasDatepicker" my_date_format="mm/dd/yy" value=""><img class="ui-datepicker-trigger" src="//assets.emailmeform.com/images/calendar.png" alt="..." title="...">
</span></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-32" class="emf-li-field emf-field-datetime data_container ">
<label class="emf-label-desc" for="element_32">Date of Expiration</label>
<div class="emf-div-field"><span class="emf-field-datetime-month">
<input maxlength="2" id="element_32_year-mm" name="element_32_month" value="" class="validate[optional,custom[onlyNumber],length[2,2],lengthValue[1,12]] emf-input-w20" type="text" size="2">
<label for="element_32_year-mm" class="emf-bottom-label">MM</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-day">
<input maxlength="2" id="element_32_year-dd" name="element_32_day" value="" class="validate[optional,custom[onlyNumber],length[2,2],lengthValue[1,31]] emf-input-w20" type="text" size="2">
<label for="element_32_year-dd" class="emf-bottom-label">DD</label>
</span><span class="emf-sep">/</span><span class="emf-field-datetime-year">
<input maxlength="4" id="element_32_year" name="element_32_year" value="" class="validate[optional,custom[onlyNumber],length[4,4]] emf-input-w40" type="text" size="4">
<label for="element_32_year" class="emf-bottom-label">YYYY</label>
</span><span>
<input type="hidden" id="element_32_" class="datepicker hasDatepicker" my_date_format="mm/dd/yy" value=""><img class="ui-datepicker-trigger" src="//assets.emailmeform.com/images/calendar.png" alt="..." title="...">
</span>
<div class="emf-div-instruction">Your passport must have an expiration date at least 6 months AFTER your trip return date. </div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-33" class="emf-li-field emf-field-new_checkbox data_container ">
<label class="emf-label-desc" for="element_33">Will you be traveling with a roommate? <span>*</span></label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_33_0" name="element_33[]" value="Yes" class="validate[required]" type="checkbox"><label class="padleft-w5" for="element_33_0">Yes</label></div>
<div class="one_column"><input id="element_33_1" name="element_33[]" value="No" class="validate[required]" type="checkbox"><label class="padleft-w5" for="element_33_1">No</label></div>
</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-34" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_34">Name of roommate</label>
<div class="emf-div-field"><input id="element_34" name="element_34" value="" size="30" type="text" class="validate[optional]"></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-35" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_35">What special occasion will you be celebrating on your trip?</label>
<div class="emf-div-field"><input id="element_35" name="element_35" value="" size="30" type="text" class="validate[optional]">
<div class="emf-div-instruction">Please provide the date of your occasion if it will be during your cruise.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-36" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_36">Cabin Category <span>*</span></label>
<div class="emf-div-field"><input id="element_36" name="element_36" value="" size="30" type="text" class="validate[required]">
<div class="emf-div-instruction">Please include Inside, Outside, Balcony, etc and letters or numbers of your cabin category</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-37" class="emf-li-field emf-field-price data_container ">
<label class="emf-label-desc" for="element_37">Cabin Category Price <span>*</span></label>
<div class="emf-div-field"><span class="emf-sep">$</span><span class="emf-field-price-dollar">
<input maxlength="15" value="" id="element_37_1" name="element_37[]" type="text" class="emf-input-w100
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<label for="element_37_1" class="emf-bottom-label">Dollars</label>
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<input maxlength="2" value="" id="element_37_2" name="element_37[]" type="text" class="emf-input-w30
validate[required,custom[onlyNumber],length[0,2]]">
<label for="element_37_2" class="emf-bottom-label">Cents</label>
</span>
<div class="emf-div-instruction">Please enter the amount without a comma. Your credit card will not be charged this amount</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-38" class="emf-li-field emf-field-textarea data_container ">
<label class="emf-label-desc" for="element_38">Cabin Requests</label>
<div class="emf-div-field"><textarea id="element_38" name="element_38" cols="45" rows="1" class="validate[optional]"></textarea>
<div class="emf-div-instruction">Please let us know if there are any special requests you have about the location of your cabin such as: the exact cabin number, if you would like to be near elevators, on a specific deck, near friends, etc.
Requests are not guaranteed.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-39" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_39">Dining</label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_39_0" name="element_39" value="Dine My Way" class="validate[optional]" checked="checked" type="radio"
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</div>
<div class="emf-div-instruction">Make reservations through the Princess Medallion app</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-40" class="emf-li-field emf-field-textarea data_container ">
<label class="emf-label-desc" for="element_40">Dietary Requirements</label>
<div class="emf-div-field"><textarea id="element_40" name="element_40" cols="45" rows="1" class="validate[optional]"></textarea>
<div class="emf-div-instruction">Please let us know of any food allergies or dietary requirements.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-41" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_41">Bed Preference</label>
<div class="emf-div-field">
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</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-42" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_42">If you have sailed with Princess Cruises before, please provide your Captain's Circle Number</label>
<div class="emf-div-field"><input id="element_42" name="element_42" value="" size="30" type="text" class="validate[optional]"></div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-43" class="emf-li-field emf-field-new_checkbox data_container ">
<label class="emf-label-desc" for="element_43">Please check here if you have sailed with Princess Cruises before and do not know your Captain's Circle Number</label>
<div class="emf-div-field">
<div my_choice_order_type="">
<div class="one_column"><input id="element_43_0" name="element_43[]" value="Please look up my Captain's Circle Number for me" class="validate[optional]" type="checkbox"><label class="padleft-w5" for="element_43_0">Please look up my
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</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-44" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_44">Are you a Veteran?</label>
<div class="emf-div-field">
<div my_choice_order_type="">
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class="padleft-w5" for="element_44_1">No</label></div>
</div>
<div class="emf-div-instruction">Discounts for veterans may be available. We will let you know if they are.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-45" class="emf-li-field emf-field-radio data_container ">
<label class="emf-label-desc" for="element_45">Is airfare included on this reservation? <span>*</span></label>
<div class="emf-div-field">
<div my_choice_order_type="">
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</div>
</div>
<div class="emf-clear"></div>
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<li id="emf-li-46" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_46">If included, what is the departure city and airport?</label>
<div class="emf-div-field"><input id="element_46" name="element_46" value="" size="30" type="text" class="validate[optional]"></div>
<div class="emf-clear"></div>
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<li id="emf-li-47" class="emf-li-field emf-field-textarea data_container ">
<label class="emf-label-desc" for="element_47">Flight Notes</label>
<div class="emf-div-field"><textarea id="element_47" name="element_47" cols="45" rows="3" class="validate[optional]"></textarea>
<div class="emf-div-instruction">Please use this space to indicate your TSA or Frequent Flyer numbers, and any requests about your seat assignments. We will do our best to apply this information to your flight reservations if possible.</div>
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<div class="emf-clear"></div>
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<li id="emf-li-48" class="emf-li-field emf-field-new_name data_container ">
<label class="emf-label-desc" for="element_48">Emergency Contact Person</label>
<div class="emf-div-field"><span style="width:60px">
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<label for="element_50" class="emf-bottom-label emf-text-center">First</label>
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<input class="validate[optional]" style="width:100%" value="" id="element_51" name="element_51" type="text">
<label for="element_51" class="emf-bottom-label emf-text-center">Last</label>
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<div class="emf-clear"></div>
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<li id="emf-li-55" class="emf-li-field emf-field-text data_container ">
<label class="emf-label-desc" for="element_55">Relationship to you</label>
<div class="emf-div-field"><input id="element_55" name="element_55" value="" size="30" type="text" class="validate[optional]"></div>
<div class="emf-clear"></div>
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<div class="emf-div-field">
<span>
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<label for="element_56_3" class="emf-bottom-label">####</label>
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<div class="emf-clear"></div>
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<span class="emf-full emf-field-new_address-addr1">
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<span class="emf-left emf-half emf-field-new_address-city">
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<span class="emf-right emf-half emf-field-new_address-state">
<input type="text" value="" id="element_61" name="element_61" class="emf-full validate[optional]">
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<span class="emf-left emf-half emf-field-new_address-zipcode">
<input type="text" value="" id="element_62" name="element_62" class="emf-full validate[optional]">
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<div class="emf-clear"></div>
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<div class="emf-clear"></div>
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<label class="emf-label-desc" for="element_64">Emergency Contact's Email Address</label>
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<div class="emf-clear"></div>
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<li id="emf-li-65" class="emf-li-field emf-field-textarea data_container ">
<label class="emf-label-desc" for="element_65">Additional Notes/Requests</label>
<div class="emf-div-field"><textarea id="element_65" name="element_65" cols="45" rows="10" class="validate[optional]"></textarea>
<div class="emf-div-instruction">If there is anything we didn't cover in the form above, please leave us a note here. Thank you!</div>
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<div class="emf-clear"></div>
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<li id="emf-li-66" class="emf-li-field emf-field-price data_container ">
<label class="emf-label-desc" for="element_66">Amount of Deposit to book your room <span>*</span></label>
<div class="emf-div-field"><span class="emf-sep">$</span><span class="emf-field-price-dollar">
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validate[required,custom[onlyNumber],length[0,2]]">
<label for="element_66_2" class="emf-bottom-label">Cents</label>
</span>
<div class="emf-div-instruction">Please enter the amount without a comma. Your credit card will be charged this amount. Your deposit will secure your reservation. The rest of your trip cost is due by your final payment date. Payments towards
your trip can be made by clicking MAKE A PAYMENT in the top right corner of our website or by calling us at 1-800-423-0247.</div>
</div>
<div class="emf-clear"></div>
</li>
<li id="emf-li-67" class="emf-li-field emf-field-new_name data_container ">
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<div class="emf-div-field"><span style="width:60px">
<input class="validate[required]" style="width:100%" value="" id="element_69" name="element_69" type="text">
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<label for="element_73" class="emf-bottom-label emf-text-center">Middle</label>
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<input class="validate[required]" style="width:100%" value="" id="element_70" name="element_70" type="text">
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<div class="emf-clear"></div>
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<br> Insurance premium (if purchased) is non-refundable.<br>
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EmailMeForm Princess Cruises Reservation Form Please fill out a separate form for each passenger. Any field marked with a red * is a required field to secure your reservation and book your cabin. You may call us at a later date with any of the other information if you do not have it at this time. PLEASE CALL 1-800-423-0247 FOR WHEELCHAIR/SCOOTER ACCESSIBLE CABIN AVAILABILITY * * Cruise Destination * * Cruise Line * Please selectPrincess * Departure Date * MM / DD / YYYY * Group Leader's Name or Group Name * You can enter "not sure" or N/A if you don't have one * Would you like a copy of your form emailed to your group leader? * Yes No By selecting Yes, you authorize Grand American Tours to forward a copy of your form to your group leader on your behalf. Passport and cc information will be omitted. * Name Prefix * Mr Mrs Ms * Name as it appears on your passport * First Middle Last Suffix There is a fee to change an incorrect name. If you are renewing your passport, please provide the name on your old passport or the name you plan to use. * Address * Street Address City State / Province / Region Postal / Zip Code * Cell Phone ### - ### - #### * Home Phone ### - ### - #### if different from your primary phone * Which is your preferred contact number? * Cell Phone Home Phone * Email By entering your email address, you will receive an email confirmation of your submission which includes a copy of the completed form. Passport and credit card information will be omitted. Confirm * Date of birth * MM / DD / YYYY * Were you born in the United States? * Yes No * If no, what country were you born in? * Passport Number This number can be found in the top right corner of the page with your picture and is 9 digits long. If you are renewing your passport, your number will change so you can leave this blank and call us when you receive the new information. Confirm * Passport Issuing Authority United States Department of State Other You should find this on the same page to the right of the issue and expiration dates. * If you checked Other, what is your passport's issuing authority? * Date of Issue MM / DD / YYYY * Date of Expiration MM / DD / YYYY Your passport must have an expiration date at least 6 months AFTER your trip return date. * Will you be traveling with a roommate? * Yes No * Name of roommate * What special occasion will you be celebrating on your trip? Please provide the date of your occasion if it will be during your cruise. * Cabin Category * Please include Inside, Outside, Balcony, etc and letters or numbers of your cabin category * Cabin Category Price * $ Dollars . Cents Please enter the amount without a comma. Your credit card will not be charged this amount * Cabin Requests Please let us know if there are any special requests you have about the location of your cabin such as: the exact cabin number, if you would like to be near elevators, on a specific deck, near friends, etc. Requests are not guaranteed. * Dining Dine My Way Make reservations through the Princess Medallion app * Dietary Requirements Please let us know of any food allergies or dietary requirements. * Bed Preference 1 Queen Bed 2 Twin Beds * If you have sailed with Princess Cruises before, please provide your Captain's Circle Number * Please check here if you have sailed with Princess Cruises before and do not know your Captain's Circle Number Please look up my Captain's Circle Number for me * Are you a Veteran? Yes No Discounts for veterans may be available. We will let you know if they are. * Is airfare included on this reservation? * Yes No * If included, what is the departure city and airport? * Flight Notes Please use this space to indicate your TSA or Frequent Flyer numbers, and any requests about your seat assignments. We will do our best to apply this information to your flight reservations if possible. * Emergency Contact Person First Last * Relationship to you * Emergency Contact's Phone Number ### - ### - #### * Emergency Contact's Address Street Address City State / Province / Region Postal / Zip Code * Emergency Contact's Email Address * Additional Notes/Requests If there is anything we didn't cover in the form above, please leave us a note here. Thank you! * Amount of Deposit to book your room * $ Dollars . Cents Please enter the amount without a comma. Your credit card will be charged this amount. Your deposit will secure your reservation. The rest of your trip cost is due by your final payment date. Payments towards your trip can be made by clicking MAKE A PAYMENT in the top right corner of our website or by calling us at 1-800-423-0247. * Name as it appears on your credit card * First Middle Last * Credit Card Information * Card Number Expiration MM / YY CVV What is this? 3 or 4 digit number printed on the back/front of your credit card Protected in vault Data collected via fields that have our security seal are encrypted and stored with the highest global security standard — PCI compliance. Your data is absolutely safe in Vault. * Billing Address if different from above Street Address City State / Province / Region Postal / Zip Code * Cancellation Policy: Insurance premium (if purchased) is non-refundable. Cancellation Policy: Airfare, pre and post nights, and motorcoach transportation, if included, and any Grand American Tours service fees are non-refundable at the time your final payment is due to Grand American Tours. Cruise fare cancellation policy is according to the cruise line website. If you are unable to access the cruise line website, please call our office at 1-800-423-0247 for your cruise line’s cancellation penalties. * BY CHECKING THIS BOX, I UNDERSTAND AND AGREE TO THE CANCELLATION POLICY AND WOULD LIKE YOU TO CHARGE MY CREDIT CARD * If you click the Submit button and nothing happens, please make sure all of the required fields are completed. * * PrevNext JanFebMarAprMayJunJulAugSepOctNovDec190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044 SuMoTuWeThFrSa 12345678910111213141516171819202122232425262728293031 Encrypting form data.