Edwards LaLone Travel, Inc.
Name of Your Travel Agent: _______________________________
PERSONAL INFORMATION (Name Must Match Photo ID Exactly)
Name:_________________________________________________________
Phone:_______________________Email:_____________________________
Address:_______________________________________________________
Date Of Birth: Month___________ Day____________ Year _____________
Passport Number:_______________________ Expires:__________________
Nationality:________________ Country Issuing Passport:_______________
Company:_____________________________ Fax Number:_____________
AIRLINE INFORMATION
Seat Preference: Aisle______ Window_______ Other_______
Frequent Flyer Number(s): Airline and Number
______________________________________________________________
______________________________________________________________
Special Meals:_____________ Other Requests:__________________________
CAR INFORMATION
Economy___ Compact___ Midsize___ Full Size___ Luxury___ Other__________
Frequent Renter Program(s):________________________________________
______________________________________________________________
Corporate Number(s):_____________________________________________
HOTEL INFORMATION
Preferences:_____________________________________________________
Nonsmoking Room: (Y/N)______ Special Requests:_______________________
Frequent Guest Number(s):_________________________________________
______________________________________________________________
OTHER INFORMATION:_____________________________________________
Email this form to your travel agent or fax to our office at: 509-747-4733.
This form can be saved to your computer to complete then emailed to us. Or it can be printed and faxed to our office.
If you have trouble downloading or printing this form, please contact our office and we can email or fax the form directly to you.
For questions and/or assistance, please call our office at:
509-747-3000 / 800-288-3788