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Greek Isles, Italy and Turkey cruise Share Request

Please put me on the roommate share list for PIED PIPER's Greek Isles, Italy and Turkey cruise Cruise. Fields marked with* are Required.

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First Name*
Last Name*
Gender * Male Female
Address*
Address 2
City*
State/Province* Choose 'N/A' for non-US/Canadian addresses
Zip/Postal Code*
Country*
Home Phone #*
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Can we leave a message?YesNo
Please tell us how you heard of us:*
(Which magazine/publication?, Which webpage?, From a 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!) No Yes
Travel Agent Name:
Travel Agent Email:
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Which categories would you like to be listed for?
IR1 - Deluxe interior stateroom $1,176
IR2 - Deluxe interior stateroom $1,186
OL1 - Premium Oceanview stateroom $1,266
BP - Deluxe Balcony stateroom (partial view) $1,366
BL1 - Premium Balcony stateroom $1,456
BL2 - Premium Balcony stateroom $1,456
BL3 - Premium Balcony stateroom $1,466
BA - Balcony Aurea stateroom $1,666
SLS - Premium Suite Aurea $2,208
YC1 - Yacht Club Deluxe Suite $3,468
YC3 - Yacht Club Royal Suite $5,708
Would you like a smoker or non-smoker as a roommate?
Non-smoker Smoker
 
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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