6292 N Via Venetia
Delray Beach, FL 33484

Phone: 202.463.2015
703.394.5255
Fax: 202.463.2017

 
 
TRAVELER PROFILE
 

In order to provide the highest quality service possible, please complete this travel profile.  All information provided will be held in strict confidence and transmitted via secured and encrypted method.

 

TSA has implemented new security procedures, mandating airlines and travel management companies to provide data on all passengers prior to departure.  This profile conforms to all current TSA requirements and will be updated periodically in compliance with present and future federal requirements.

 

  *= Required Fields
Traveler’s Name (as it appears exactly on official identification or passport):
First Name:*
Middle Name(s):
Last Name:*
Gender:*
Male Female  
     
Date of Birth:* Month- Day- Year- Why?
When passengers travel, they will be required to provide the following Secure Flight Passenger Data (SFPD) to their airline when making a reservation: 1)Name as it appears on government-issued I.D. when traveling, 2)Date of Birth, 3) Gender. For more info, please click here now.
    
Redress Number:
(if applicable) 		What is it?
The Department of Homeland Security Traveler Redress Inquiry Program (DHS TRIP) is a single point of contact for individuals who have inquiries or seek resolution regarding difficulties they experienced during their travel screening at airports. Those who believe they have been mistakenly matched to a name on the watch list are invited to apply for Redress through DHS TRIP. Secure Flight uses the results of the redress process in its watch list matching process, thus preventing future misidentifications for passengers who may have a name that is similar to an individual on the watch list. For more information on the redress process, click here now.
  
   
Home Airport:
   
Contact Information:
Name of the Person arranging travel: * Self:  
Company Name:
Company Address: Street:
 
City: State:
 
Zip: Country:
Email Address 1:*
Email Address 2:
Phone Number 1:*
Phone Number 2:
Phone Number 3:
Home Address:* Street:
 
City: State:
 
Zip: Country:
Emergency Contact Name:*
Emergency Contact Phone: *
Emergency Contact Email:
   
Passport Information: (International Travelers): Why?
Click here for more information.
    
Name (exactly as it appears):
Citizenship:
Passport Number:
Place of Issue:
Date of Issue: Month- Day- Year-
Expiration Date: Month- Day- Year-
   
Credit Card Information:
BUSINESS TRAVEL:
Card Type: If Other Card Type:
Card Number:
Card Expiration: Month- Year-
Card Holder's Name:
Card Usage:
All: Hotel: Air: Auto: Other:
   
PERSONAL TRAVEL:
Card Type 1: If Other Card Type:
Card Number 1:
Card Expiration 1: Month- Year-
Card Holder's Name 1:
Card Usage 1:
All: Hotel: Air: Auto: Other:
   
Card Type 2: If Other Card Type:
Card Number 2:
Card Expiration 2: Month- Year-
Card Holder's Name 2:
Card Usage 2:
All: Hotel: Air: Auto: Other:
   
Agreement:
 

I/we authorize Profile Travel and Tours to charge my credit card electronically without my signature, all travel related services, including but not limited to service fees, cancellation penalties and surcharges. I agree to pay all the charges as they appear on my credit card statement. Before disputing any charges, I hereby agree to contact Profile Travel and Tours to clarify the charges and check the status of any impending credits and voids. Please be aware that airline/vendor charges do appear instantly on your account while credits and voids may take up to four weeks. This is due to the nature of how airlines settle through the Airline Reporting Corporation (ARC), the clearing house that processes all credit card payments. Submitting this profile represents your agreement to pay all your credit card charges/invoices.

I agree:*

Your Initials:*
   
Air Travel:
Airline Preference: If Other:
Airline Frequent Flyer Program #:
Airline Frequent Flyer Program 2 #:
Airline Frequent Flyer Program 3 #:
Level Status:
Class of Service:
Economy (Non-refundable): Economy (Flexible)):  
Economy Plus: Business: First:
Would you be interested in special upgrades for nominal surcharge?
Would you be interested in wholesale tickets with savings on published rates:
Would you be using your mileage/payup for upgrades?
Seat Preference:
Aisle Window No Pref.
Special Meal Request:
Special Air Request: (i.e. Medical, wheelchair assist:)
   
Hotel Preference:
We offer “Premiere Preferred” worldwide discounted rates and ongoing special promotions.
Your Corporate Hotel Program:
Hotel Chain:
Other Hotel 1:
Other Hotel 2:
Room Type:
Smoking Non-Smoking King Double
Type of Hotel:
Basic 4 Star 5 Star+
Special Hotel Request:
   
Car Rental Preference:
Corporate Car Program:
Membership #:
Type of Vehicle:
   
Special Request/Preferences:
Are you interested in Trip Cancellation Insurance?
Yes No
Please tell us how we could better serve you. Let us know of any special needs, requirements, and requests:
   
Would you like us to add your email address to our "promotional specials" list?:
Yes No
   
Registration Code:*

 
   
  Thank you for your time!
   
 
   
   
     
     
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