Use this form to create/update your personal profile. If you're creating a new profile, please fill out each section as completely as possible. If you are updating a current profile, you only need to fill out the additions or corrections you want to make. Please be sure to fill in the Traveler Name and Company Name fields, even if you're just updating. This information is what we use to locate your current profile in our computer reservation system. If you have any problems or questions, you can send an email to Passport Executive Travel in the Georgetown office.
Personal data
New Profile Updated Profile
Travelers Name as on
Passport or ID:*
Company Name:* Dept:
Company Address:
City/State/Zip:
Phone: Office FAX:
Phone: Home E-Mail:*
Phone: Cell    
 
Travel Arranger: Phone:

* = Required Field
Airline Travel
Pre-assigned seating
Non-smoking Smoking Aisle Window
Bulkhead Forward Rear Other:

Special meals
Diabetic Fruit Kosher Low Fat
Seafood Vegetarian Other:

Frequent flier memberships (Please indicate membership number):
American: United:
Delta: US Airways:
Continental:    
Northwest: Other (specify):
Other (specify): Other (specify):
NOTE: Carriers require an exact match of your name as it appears on your ticket with the name shown on your frequent flier card. The tracking systems are not, for example, able to match a passenger with the name of JB Doe with a membership for John B. Doe. You must contact each individual airline to change your membership to reflect use of one name consistently.
Hotel information
List any frequent guest program membership numbers:
Hilton: Radisson:
Hyatt: Ramada:
Holiday Inn: Sheraton:
Marriott: Other (specify):
Other (specify): Other (specify):

Special Requirements
Room Type: Non-Smoking Smoking Special Request Disability
King Double Twin

Credit card for room guarantee:
Card Type: Number: Exp. Date:
    Security Code:  
Car rental information
List any frequent renter program membership numbers:
Avis: Hertz:
Alamo: National:
Budget: Other (specify):
Other (specify): Other (specify):

Preferred Car Size:
Luxury Full Size Mid-Size
Compact Economy Non-Smoking
Other (specify):
International travel information
Many airlines now require that passport numbers be entered into the flight records of international travelers.
Name (Exactly as issued):
Passport Number and Nationality: Date of Issue:
Place of Issue: Expiration:
Emergency Contact: Phone:
Credit card information
Business Travel
Card Type: Number: Exp. Date:
Personal Travel
Card Type: Number: Exp. Date:
Card Type: Number: Exp. Date:

I, hereby authorize Passport Executive Travel to make charges to my credit card.
Comments / Special instructions
Please advise us with any additional information and/or comments in the space provided below.

The travel consultant I normally speak with is: