Client Travel Profile & Prefrences

This field is hidden when viewing the form

Source

Name (as appears on passport)*

Please establish a Personal Travel Account in my name according to the travel preferences I have indicated. I authorize “Pascale Travel / Brownell" to charge to my credit card the travel transactions requested by my authorized agent or me. I understand I will be responsible for any changes resulting from such a request and in the event the credit card company dishonors a request for payment by Pascale Travel / Brownell, for any travel arrangements, I agree to reimburse Pascale Travel / Brownell for the cost of the travel arrangements so dishonored.

First Middle Last

Company Name

Company Info

City State / Province / Region ZIP / Postal Code

Home Address

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

Preferred Email Address*

This field is hidden when viewing the form

Date

Home Phone

Cell Phone

How many people in your family will be traveling? (including yourself)*

1
2
3
4

Passport Information

Our New policy required a copy of your passport Allowing us to have accurate info for flight reservations etc..

Date of Birth

Citizenship

Wedding Anniversary Date

Airline Information

Preferred outbound airport

I need transportation to/from the airport

Yes
No

How many frequent flyer accounts do you have?

1
2
3
4 or more

Frequent Flyer Airline

Frequent Flyer Number

Name as it appears on Account

Frequent Flyer Airline #2

Frequent Flyer Number

Name as it appears on Account

Frequent Flyer Airline #3

Frequent Flyer Number

Name as it appears on Account

Frequent Flyer Airline #4

Frequent Flyer Number

Name as it appears on Account

Passport Information: Family Member #1

Our New policy required a copy of your passport Allowing us to have accurate info for flight reservations etc..

Name (as appears on passport)*

First Middle Last

Date of Birth

Citizenship

Airline Information: Family Member #1

Airline Seat Preference

Airline Meal Preference

How many frequent flyer accounts does family member #1 have?

1
2
3
4 or more

Family Member #1: Frequent Flyer Airline

Family Member #1: Frequent Flyer Number

Family Member #1: Name as it appears on Account

Family Member #1: Frequent Flyer Airline

Family Member #1: Frequent Flyer Number

Family Member #1: Name as it appears on Account

Family Member #1: Frequent Flyer Airline

Family Member #1: Frequent Flyer Number

Family Member #1: Name as it appears on Account

Family Member #1: Frequent Flyer Airline

Family Member #1: Frequent Flyer Number

Family Member #1: Name as it appears on Account

Passport Information: Family Member #2

Our New policy required a copy of your passport Allowing us to have accurate info for flight reservations etc..

Name (as appears on passport)*

First Middle Last

Date of Birth

Citizenship

Airline Information: Family Member #2

Airline Seat Preference

Airline Meal Preference

How many frequent flyer accounts does family member #2 have?

1
2
3
4 or more

Family Member #2: Frequent Flyer Airline

Family Member #2: Frequent Flyer Number

Family Member #2: Name as it appears on Account

Family Member #2: Frequent Flyer Airline

Family Member #2: Frequent Flyer Number

Family Member #2: Name as it appears on Account

Family Member #2: Frequent Flyer Airline

Family Member #2: Frequent Flyer Number

Family Member #2: Name as it appears on Account

Family Member #2: Frequent Flyer Airline

Family Member #2: Frequent Flyer Number

Family Member #2: Name as it appears on Account

Passport Information: Family Member #3

Our New policy required a copy of your passport Allowing us to have accurate info for flight reservations etc..

Name (as appears on passport)*

First Middle Last

Date of Birth

Citizenship

Airline Information: Family Member #3

Airline Seat Preference

Airline Meal Preference

How many frequent flyer accounts does family member #3 have?

1
2
3
4 or more

Family Member #3: Frequent Flyer Airline

Family Member #3: Frequent Flyer Number

Family Member #3: Name as it appears on Account

Family Member #3: Frequent Flyer Airline

Family Member #3: Frequent Flyer Number

Family Member #3: Name as it appears on Account

Family Member #3: Frequent Flyer Airline

Family Member #3: Frequent Flyer Number

Family Member #3: Name as it appears on Account

Family Member #3: Frequent Flyer Airline

Family Member #3: Frequent Flyer Number

Family Member #3: Name as it appears on Account

Your Emergency Contact Information

Name

First Last

Relationship

Phone

Email

Address

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

Car Rental Information

Car Size Preferred

Frequent Renter Program: Car Rental Company

Frequent Renter Program: Personal/Frequent Renter Number

Frequent Renter Program: Car Rental Company

Frequent Renter Program: Personal/Frequent Renter Number

Hotel Information

Room Preferences

Special Requests to Hotel

Discounts

Hotel Club Programs

Hotel Name

Personal/Frequent Guest Number

Hotel Name

Personal/Frequent Guest Number

Hotel Name

Personal/Frequent Guest Number

Other Information

Please let us know of any other information that may help us provide you with the best possible service!

Let Us Better Serve You

1. What type of vacations have you taken in the past?

What kind of cruise?

Below are general interests. Please check those that best describe the type of travel you like.

Below are focused hobbies and interests. Please check those that best describe you.

What is your most common trip budget? (per person)

Up to $3,000
$3,000 to $8,000
$8,000 to $15,000
Over $15,000

How many times per year do you vacation?

1
2 to 3
3 to 5
Over 5

On average, how long do you trips last?

10 days or less
11 to 20 days
Over 20 days

Please check all boxes that best apply to you.

List your favorite cruise line(s)

What 3 countries are on your top bucket list:

4 + 7=*

Please enter a number that represents 4 + 7

CAPTCHA