Walt Disney World Quote Request Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Your Travel DatesAre your dates flexible? If yes, enter date rangeArrival Date MM slash DD slash YYYY Departure Date MM slash DD slash YYYY Your 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 AccommodationsEnter The Disney Resort Hotel You Want, OR Type Any, and we can help you decideHow many rooms?How many days of tickets?Additional features for your tickets (select all that apply) Park Hopper Water Park & Sports Additional Information:Select an AgentAny AgentAlex MurphyAlicia von KugelgenAlyssa LawrenceAmanda McKinneyAmy AnstettAmy DodardAnna PretkoApril KraftBob AngeloBrenda KenworthyBrittany PerkinsCaitlyn ElliottCathy MartinCheryl DoyleChris SharpsChristy DudleyCorinne TriggCourtney GiddingsCris BravoDayna RiceDebbie MatulloDebbie NebelDenise LewisDiana SimpsonDonna DeGiacomoEmily Moore StammErin McKeeGinifer GrumboGreg SethmanJamie McCarthyJen LahmannJenni BorskiJennifer WebsterJenniferMarie HughesJohn BarbianJulianne MarmolJulie DaviesKatie BrittleKelly BiasKelsey NewberryKendra CrameKim ThommesKourtney KantorKristen HugginsKristen MakinsKristi NoyesKristin ZarchanKristyn HabickLesli TerzoLynne Marie PisanoMegan GrangerMegan MoodyMeghan LozanoMeghan SgambatiMichelle SeitherMike EllisMisty FlippoMonica EnglehartNicole RaglandNina PatelPatty GilesRobert BucherShawn JanofskiSkylar HyattStacey FrostStefanie GladfelterStephanie SeveranceStephanie WernerTammy FranklinTawny CooperTiffany DehnTom BarnesTracey RobbinsWhitney VanstoryZoe DorworthThis is my first request with Pixie Vacations: Yes No Travel Insurance. Include in this quote? Yes No Would 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 3 days the reservation simply goes away.What Website, Friend, Story, can we thank for telling you 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 CompanyΔ
