Registration Form

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Contact Information
E-mail Address*
First Name*
Last Name*
Address line 1
Address line 2 (suite, apt., etc.)
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Other address (international)
Postal Code
Day telephone
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Notification Preferences
Do you wish to receive e-mail notifications regarding travel promotions?*	Yes No
Do you wish to receive e-mail notifications about last minute deals?*	Yes No
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Would you like to receive our newsletter electronically (through e-mail notification and availability on the web) or direct mail (postal delivery)?*	Electronically Direct Mail

Travel Preferences

Favorite Cruise Lines. Check all that apply:

Destination Preferences. Check all that apply:

*Cruise Tours:*
	Are you interested in land tours combined with a cruise?	Yes No
	Are you interested in customized shore excursions?	Yes No

Previous Booking Information
Have you booked with Kelly Cruises Before?	Yes No
If you have booked before, who was your agent?

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