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On-Line Travel Services Request


Requester's Information: Please provide detailed information

Last Name: , First Name:

E-mail:   (E-mail or Phone field (s) Must be Completed)

Work Phone # with Area Code: , Home Phone # with Area Code:

Best Time to Call: , Fax # with Area Code:

( Phone/Fax numbers are very helpful, as sometimes there may be problems reaching you via Email )

What services, information or help you need ?

How did you hear about us ? (search engine name or site info)

Search Criteria:
(Key words used for search)


Detailed Information about your request


Your Proposed Itinerary: Please provide full names of all the persons travelling (as the names appear in a Picture ID such as passport or driver license), in the box below:

From (City, State and Country, if not USA):

To (City, State and Country, if not USA):

Departure Date:
Do you need a Round Trip ticket :

Return Date: (Leave blank, if it is one way only)

Number of Passengers: , Adult (s): , Child (ren): , Infant (s):

(Normally Child is less than 12 years, & infant is less than 2 years of age)

If more than one person is travelling, or if travel dates are different, or there is a child travelling give information below:

Passenger 1 - Last-Name: First: Age: Departure: Return:

Passenger 2 - Last-Name: First: Age: Departure: Return:

Passenger 3 - Last-Name: First: Age: Departure: Return:

Passenger 4 - Last-Name: First: Age: Departure: Return:

Passenger 5 - Last-Name: First: Age: Departure: Return:

Passenger 6 - Last-Name: First: Age: Departure: Return:

May we assist you with your Hotel, Car rental, Travel Insurance, needs ? Provide details below:


IMPORTANT NOTE FOR INTERNATIONAL TRAVELERS: Please make sure that you have a valid passport & visa documents for your travel destination and transit points. If you have a question call the consulate general of the country or the airline on which you are going to fly for details. Consult your physician for health related questions. Evaluate your travel insurance needs with your insurance agent. Leave copies of important travel documents like passport, green card etc. with your travel agent or a friend so it can be faxed to you in case of lost or theft of these documents. In case of stopover do not forget to intimate the airline of your local telephone number. You may want to discuss arrangements with your travel agent for emergency situations.


Authorization:

  • Dear AA To Z Travel:
    Please make the booking if necessary, and send me a price quote.
Thanks for you time. If we are able to help you, we will reply ASAP

 

 

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Last modified: November 28, 2006