Customer’s Assessment and Eligibility Form

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Customer’s Assessment and Eligibility Form

Let’s get to know you!

We’re happy to guide and advise you on the suitable travel plans and the best destinations.

Kindly fill the form below, and someone at the other side of the form is waiting to respond to you!

Step 1: Personal Information

Step 2: Educational Background

Step 3: Travel Details

Step 4: Travel Interests

Step 5: Special Requests

Step 6: How Did You Hear About Us?

Step 7: Preferred Contact Method

Step 8: Any Other Message?

Your Full Name (surname in CAPITALS) Your Email Address Your Phone Number Your Alternative Phone Number Your Full Address (including City, State, Country, ZIP)

Your Educational Background WAEC / NECO / GCE-O LEVEL / GCE – A LEVEL / BACCONDBSCMSCPHD

Your Destination(s) Your Preferred Start of Travel Date Your Preferred End of Travel Date Trip Duration Number of Adults Number of Children (if applicable) Your Accommodation Preferences Your Budget

State Your Travel Interests Conferences/WorkshopsCultural SightseeingStudy PackagesWork PackagesVolunteer PackagesForeign Languages Training (IELTS and TOFEL)Hotel Reservations/FlightBookingsTour PackagesOthers (Please Specify) Specify Other Travel Interests

State Your Special Requests Travel Insurance RequiredVisa RequiredAdditional Services

How Did You Hear About Us? Online SearchFriend/Family RecommendationSocial MediaOur WebsiteOthers (Please Specify Source) Specify Other Sources Where You Heard About Us

What's Your Preferred Contact Method? EmailPhone

Do You Have Any Other Message (optional)

All the best,

La Viv Travels Limited

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