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Repositioning cruise from New York to the Caribbean Share Request

Please put me on the roommate share list for PIED PIPER's Repositioning cruise from New York to the Caribbean Cruise. Fields marked with* are Required.

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First Name*
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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:
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Travel Agent Address:
Which categories would you like to be listed for?
12 - Inside double stateroom $1,279
11 - Inside double stateroom $1,311
10 - Inside double stateroom $1,343
9 - Inside double stateroom $1,375
Y - Ocean-view double stateroom with window guaranty $1,231
8 - Ocean-view double stateroom with window $1,519
7 - Ocean-view double stateroom with window $1,551
6 - Ocean-view double stateroom with window $1,615
IO - Panoramic Oceanview stateroom $1,543
X - Deluxe ocean-view double stateroom with veranda guaranty $1,311
P2 - Deluxe Porthole view w/Veranda stateroom $1,599
P1 - Deluxe Porthole view w/Veranda stateroom $1,639
EX - Edge stateroom w/ Infinite Veranda guaranty $1,591
E5 - Edge stateroom w/ Infinite Veranda $1,879
E4 - Edge stateroom w/ Infinite Veranda $1,879
E3 - Edge stateroom w/ Infinite Veranda $1,911
E2 - Edge stateroom w/ Infinite Veranda $1,943
E1 - Edge stateroom w/ Infinite Veranda $2,023
XC - Concierge Class guaranty $1,871
C3 - Concierge Class double stateroom with veranda $2,159
C2 - Concierge Class double stateroom with veranda $2,279
C1 - Concierge Class double stateroom with veranda $2,399
XA - Aqua Class stateroom with veranda guaranty $2,271
A2 - Aqua Class stateroom with veranda $2,559
A1 - Aqua Class stateroom with veranda $2,679
AS - Aqua Class Sky Suite with floor-to-ceiling windows and veranda $4,879
S3 - Sky Suite with floor-to-ceiling windows and veranda $3,719
S2 - Sky Suite with floor-to-ceiling windows and veranda $3,999
S1 - Sky Suite with floor-to-ceiling windows and veranda $4,159
AS - Aqua Class Suite $4,879
CS - Celebrity Suite with floor-to-ceiling windows $6,479
RS - Royal Suite with floor-to-ceiling windows and veranda $9,279
IC - Iconic Suite $22,399
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