T R A V E L E R   P R O F I L E
 

CONFIDENTIAL 

The following information enables us to individually customize your travel arrangements.  Providing us with this information now will save you time in the future.  Please fill out the following information and automatically send it to us by clicking "submit".  Or, if you prefer, complete the form, print it out on your printer and either fax or mail it to:

Gateway Travel
41 Main Street
Brattleboro, VT  05301

Fax: (802) 257- 5325

 

 

 

 

 
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Traveler Information     

Travel Arranger (If Relevant)

Full Name:           

Travel Arranger:

Title:                    

Travel Arranger Phone:

Company:           

Travel Arranger Fax:

Division/Dept:   

Travel Arranger E-mail:

Office Address

Home Address

Address:

Address:

City:      

City:      

State:           Zip Code:

State:             Zip Code:

Work Phone: Home Phone:
Work Fax:      Home Fax:     
Business E-Mail:   Personal E-Mail: 

Prefer my tickets sent to: Office  Home Travel Arranger
 

Passport Information:

 

Passport #:            

Exp:                         Citizenship:

Name on Passport:

Date of  Issue: Birth Date:

   
Credit Card  Information:  

For Airline Tickets:

Card Type:   


Card Number:
Exp. Date:       

Name as it Appears on Card:

For Hotel Guarantee:

Card Type:     


Card Number: 
Exp.  Date:         

Name as it Appears on Card:
For Personal Travel:

Card Type:     

Card Number:
Exp.  Date:        

Name as it Appears on Card:

 

 

Airline Seating Preference

Special Meal Requests

1st Choice:            

1st Choice:   

2nd Choice:           

2nd Choice:

       Smoking       Non-Smoking

Frequent Flyer Information

Airline:

ID#:

Airline:

ID#:

Airline:

ID#:

Airline:

ID#:

Airline:

ID#:

Airline:

ID#:

Airline:

ID#:

Hotel Memberships

Hotel:

ID#:

Hotel:

ID#:

Hotel:

ID#:

Hotel:

ID#:

Hotel:

ID#:

         
Hotel Preference:    

Hotel  Special Requests:          

   Hotel Room Preferences: Smoking    Non-smoking

Car Rental Memberships

Car Rental Co. 

ID#:

Car Rental Co. 

ID#:

Car Rental Co. 

ID#:

                                                       Car Preference:

 
Family Information: (Include household members, their Frequent Flyer Number and children's date of birth)
Name & Information:
Name & Information:
Name & Information:
Name & Information:

Please add any other information that will help us to serve you better:

 

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