Walt Disney World Quote Request Name*FirstLastAddress*Street AddressCityState / Province / RegionZIP / Postal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweCountryPhone*Email*Your Travel DatesArrival Date Departure Date Are your dates flexible? If yes, enter date rangeYour Travel PartyHow many adults in your party (ages 18 and up)?: How Many Children in your party?What are the ages of the children?:Walt Disney World Resort AccommodationsPlease select your preferred resort:All Star Movies - ValueAll Star Music - ValueAll Star Sports - ValueArt of Animation - ValuePop Century - ValueCaribbean Beach Resort- ModerateCoronado Springs Resort - ModeratePort Orleans Riverside - ModeratePort Orleans French Quarter - ModerateFort Wilderness Cabins - ModerateAnimal Kingdom Lodge - DeluxeBeach Club Resort - DeluxeBoardwalk Inn - DeluxeContemporary Resort - DeluxeGrand Floridian Resort - DeluxePolynesian Resort - DeluxeWilderness Lodge - DeluxeYacht Club Resort - DeluxeBay Lake Tower - Deluxe VillaBeach Club Villas - Deluxe VillasBoardwalk Villas - Deluxe VillasOld Key West Resort -Deluxe VillasSaratoga Springs Resort and Spa - Deluxe VillasWilderness Lodge Villas - Deluxe VillasFort Wilderness Campground CampsitesPlease select your second choice resort:All Star Movies - ValueAll Star Music - ValueAll Star Sports - ValueArt of Animation - ValuePop Century - ValueCaribbean Beach Resort- ModerateCoronado Springs Resort - ModeratePort Orleans Riverside - ModeratePort Orleans French Quarter - ModerateFort Wilderness Cabins - ModerateAnimal Kingdom Lodge - DeluxeBeach Club Resort - DeluxeBoardwalk Inn - DeluxeContemporary Resort - DeluxeGrand Floridian Resort - DeluxePolynesian Resort - DeluxeWilderness Lodge - DeluxeYacht Club Resort - DeluxeBay Lake Tower - Deluxe VillaBeach Club Villas - Deluxe VillasBoardwalk Villas - Deluxe VillasOld Key West Resort -Deluxe VillasSaratoga Springs Resort and Spa - Deluxe VillasWilderness Lodge Villas - Deluxe VillasFort Wilderness Campground CampsitesIf you have a third or fourth resort quote request please list it in the Notes section.How many rooms?Do you want to add the dining plan?YesNoMagic Your Way Tickets: Select the number of days for your park tickets.None12345678910 Additional features for your tickets (select all that apply) Park Hopper Water Park Fun & MoreNo Expiration OptionDiscountsWe will search the current Disney Package Discounts to get you the best price. There may be discounts as well if you have one of the following:Disney Visa: Do you have a Disney Visa card?YesNoAnnual Pass: Do you have a WDW Annual Pass?YesNoAdditional Information:Select An AgentAny AgentAmy CarverAmy St JeanAngelica HawkinsAnna PretkoAnthony PicozziApril TaylorBob AngeloBrandon BarbaBrenda KenworthyBridget CampiChad WalkerCherise ElderChris & Jessie SharpsChris ShivelyChris WoodChristine ThompsonChristy DudleyDanielle InmanDawn InmanDebbie MatulloDebbie NebelDenise CherryDiane MendozaDonna DegiacomoDulcie HaysElescia DuplessisEmily RoachGinger HensonJenn PhelpsJennifer WebsterJennifer Marie HughesJess HayesJim WittJodi LintonJodie Maesaka-HirataJulie GableKatie GreerKelly BiasKrissy ShawKristin ZarchanLauren MasarikLisa GriswoldLesley SawhookLeslie HarrisLynne PisanoMeghan LozanoMatt CarerraMatthew MassonMichele DakhoMike EllisMisty FlippoNatalie BrowningNathan BakerPatty GilesPaul HelmuthRobin BoggsScott ShowenSharon CoxStacey BravataSteve KusnerTabitha WoodwardTasha RatliffTony BunossoTonya JordanTracey RobbinsThis is my first request with Pixie Vacations:YesNoTravel Insurance. Include in this quote?YesNoWould you like us to HOLD a reservation for you while you look it over? Rooms and specials at Disney World book quickly. We can put a complementary hold on your reservation for seven days while you review the quote. To do a hold, we need your phone number and everyone's first and last name in the party. You can enter everyone's names in the Notes field at the bottom of the form. No credit card is needed and you are not committed. If you do not book within 7 days the reservation simply goes away.Do you want us to place a reservation on hold for you (ALL names are required in the Notes section below): YesNoWhere did you hear about us?NotesPlease indicate any additional information so we can be sure to plan the Walt Disney World vacation that is just right for you. If you would like air quoted in your Disney Vacation, please add your airport code. When you submit this form we will contact you with pricing. Rates and specials are subject to change prior to booking your reservation by making a deposit. I have read and agree to these Terms of Service. I understand these terms and conditions and cancellation policies set by the Walt Disney Travel Company & the Walt Disney Company
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