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Traveler Profile Form

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TRAVELER INFORMATION

Name*

First Name Middle Name Last Name

Title

Position

Company

Email*

Cell Phone

Preferred Departure Airport

Alternate Airport Fare Check

PERSONAL INFORMATION

Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Name

Relationship

Emergency Contact Phone

SECURE FLIGHT INFORMATION

Used to send airlines more detail for security reasons. Please enter your name exactly as it appears on your passport or Government documentation that you will be presenting at the airport. For more information please refer to www.tsa.gov. *Denotes required field.

Name*

First Name Middle Name Last Name

Birth Date*

MM slash DD slash YYYY

Gender*

Male

Female

Redress Number

Address

State / Province / Region Country

Traveler Number

Address

State / Province / Region Country

AIRLINE INFORMATION

List in order of preference - Please note Company preferences take priority.

Special Meal Request

Seat Preference

Aisle

Window

Front

Middle

Rear

Other

Airline 1

FF#

Airline 2

FF#

Airline 3

FF#

Airline 4

FF#

HOTEL INFORMATION

List in order of preference - Please note Company preferences take priority.

Special Room Request

I Prefer:

Smoking

Non-Smoking

Are you a AAA member?

Yes

AAA Membership Number

Hotel 1

Hotel 2

Hotel 3

Hotel 4

PASSPORT/VISA INFORMATION

Gender

Male

Female

Citizenship

Date of Birth*

MM slash DD slash YYYY

Passport Number

Name as it Appears on Passport

First Name Middle Name Last Name

Country of Issue

Country

Issue Date

MM slash DD slash YYYY

Expiration Date

MM slash DD slash YYYY

Featured Sample of past and present

Corporate Clientele

★★★★★

We had an unbelievable vacation in San Diego, despite of ear infections and cold...

The Sweeneys

★★★★★

We had an unbelievable vacation in San Diego, despite of ear infections and cold weather. The hotel accommodate all the needs of our family and the city itself is fantastic for families. Our daughter needs usually limits how many’s activities we can do, and this trip was no exception. The setup of the Shore house allowed for my other two to explorer and play while Catherine could stay where she was comfortable. The air travel was great and I ended up adding premier access so that we could zip Catherine through security.

The Sweeneys

★★★★★

We have been using this agency for decades. I feel confident sending my employees overseas ...

Mara McClain

RIZZO International, Inc.

★★★★★

We have been using this agency for decades. I feel confident sending my employees overseas knowing that Alan and his team will be able to assist with whatever issues arise with their travel. The personalized touch in travel planning is sublime.

Mara McClain

RIZZO International, Inc.

★★★★★

I travel pretty much weekly for my job. Their knowledgeable, professional and courteous staff help ...

Jim Begley

Moretto USA

★★★★★

I travel pretty much weekly for my job. Their knowledgeable, professional and courteous staff help make my job so much easier. From last minute bookings to flight cancellations and delays, they are always prompt in meeting my needs. The personal attention that Alan, Kim and the entire staff convey, most certainly rate five stars from myself and our company. Keep up the exceptional service!

Jim Begley

Moretto USA

★★★★★

Very, very pleased with the service and their attentiveness to all of our travel needs ...

Michele Holzworth

Framesi NA

★★★★★

Very, very pleased with the service and their attentiveness to all of our travel needs both domestic and international. Alan and his team goes above and beyond to make sure everything is smooth, no surprises, and reacts immediately when needed.

Michele Holzworth

Framesi NA



412.232.3600



800.232.2016 (Toll Free)



412.232.3070 (Fax)



[email protected]

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EPEX Travel is proud to be a women-owned business located in Pittsburgh, Pennsylvania.

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Featured Sample of past and present

Corporate Clientele

412.232.3600

800.232.2016 (Toll Free)

412.232.3070 (Fax)

[email protected]

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Corporate Travel

Leisure Travel

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