Please print the following form, fill in as much information as possible, and mail or fax to your travel agent.

Please put me on the roommate share list for PIED PIPER's gay group cruises:

Full Name __________________________________________________________

Address ___________________________________________________________

City _________________________ State _______ Zip Code _____________

Telephone (Home) ________________________ (Work)__________________

Best time and place to reach me: ________________________________________

Can we leave a message? ___Yes____No.

Please tell us how you heard of us: (Which magazine/publication?, Internet link-Which webpage?, friend/previous passenger, etc.) ___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

Do you currently have a favorite travel agent? (PIED PIPER pays commissions to certified travel agents for its gay group cruises!)

Travel Agent's name _____________________ Telephone #_________________

Travel Agency name _____________________ Agency Fax # ________________

Travel Agency address ________________________________________________

Please list the particular PIED PIPER gay group cruise you would like a roommate share for:

_______________________________________________________

Which categories would you like to be listed for? _____________________

Would you like a smoker or non-smoker as a roommate? _____________________

Thank you for your interest in our cruises! We will call you as soon as we find a roommate for you to make sure you're still interested. Hope to see you onboard!

PLEASE NOTE THAT ALL PAYMENTS MADE FOR SHARE RESERVATIONS ARE NON-REFUNDABLE UNLESS A SHARE REPLACEMENT CAN BE FOUND

Return to Gay Group Cruises