Hotel and land packages Information Form


Please complete this form for each person traveling with you or staying in your room. (You may also print this page, complete it and fax it to 909-798-5130.) Once received an agent will contact you via phone for deposits or payments. Your reservation is not confirmed until a deposit is received.

Names must appear exactly as they do on your official documents (Passport) that you will present the authorities and/or airline as identification (no nicknames).

WE HIGHLY RECOMMEND TRAVEL PROTECTION – PLEASE CALL US FOR DETAILS ON INSURANCE BENEFITS AND PREMIUM!

Destination:
Travel Dates
Depart:
Return:
Emergency Contact:

Guest #1

*Title:	(please choose one)Mr.Mrs.Ms.Dr.
*First Name:
*Last Name:
*Passport Number:
*Passport Expiration Date:
*Street Address:
*City, State, Zip Code:
*Email Address:
*Phone Number with Area Code:
*Date of Birth (Day, Month, Year):
Citizenship:
Number per room:
Emergency Contact:
Emergency Contact Phone:
Special Needs (diet or other) or Special Occasions:

Guest #2

*Title:	(please choose one)Mr.Mrs.Ms.Dr.
*First Name:
*Last Name:
*Passport Number:
*Passport Expiration Date:
*Street Address:
*City, State, Zip Code:
*Email Address:
*Phone Number with Area Code:
*Date of Birth (Day, Month, Year):
Citizenship:
Number per room:
Emergency Contact:
Emergency Contact Phone:
Special Needs (diet or other) or Special Occasions:

Guest #3

*Title:	(please choose one)Mr.Mrs.Ms.Dr.
*First Name:
*Last Name:
*Passport Number:
*Passport Expiration Date:
*Street Address:
*City, State, Zip Code:
*Email Address:
*Phone Number with Area Code:
*Date of Birth (Day, Month, Year):
Citizenship:
Number per room:
Emergency Contact:
Emergency Contact Phone:
Special Needs (diet or other) or Special Occasions:

Guest #4

*Title:	(please choose one)Mr.Mrs.Ms.Dr.
*First Name:
*Last Name:
*Passport Number:
*Passport Expiration Date:
*Street Address:
*City, State, Zip Code:
*Email Address:
*Phone Number with Area Code:
*Date of Birth (Day, Month, Year):
Citizenship:
Number per room:
Emergency Contact:
Emergency Contact Phone:
Special Needs (diet or other) or Special Occasions:

Check this box indicating that you understand that your reservation is not confirmed until we have received your deposit. (An agent will contact you to make payment arrangement for your deposit.)