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Passenger Information Form

Please enter each passenger’s FULL name (first, middle, last), date of birth, and gender as the information appears on the identification which will be used when traveling.

Travelers 18 and over will all be required to sign the agency’s General and COVID Disclaimer before payment can be applied. Please provide individual email address to assist in this process.

Passport Details

Name as it appears on this passenger's ID that will be used for travel

For some people, names on their driver's license are different from their names on their passport. Please consult your proper form of ID for the correct information.

First Name(s) *

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Is there a middle name listed on your passport? *

Yes
No

Middle Name(s) *

Last Name(s) *

Gender *

Date of Birth *

Citizenship *

Contact Information

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Preferences and Further Information

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Have you received a COVID19 vaccination? *

Yes
No

Vaccination Details *

Single dose vaccination (ie Johnson/Johnson)
One dose of multi-dose vaccine
Two doses of multi-dose vaccine
Fully vaccinated + booster

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Do you have special needs/requests such as meals, pets, or mobility?

Yes
No

Special Needs/Requests *

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Are you part of any of the following groups

Active Military
Retired Military
AARP
U.S. Law Enforcement
Canadian Law Enforcement
Fire Department or EMT

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Do you have any of the following passenger identification numbers?

TSA Pre
Known Traveler
Redress
Other

TSAPre *

Known Traveler *

Redress *

Other *

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Do you have preferences about your seating on a plane?

Yes
No

Seat preference *

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Do you have frequent flyer accounts?

Yes
No

Accounts *

Alaskan Airlines
American Airlines
British Airways
Delta Airlines
Emirates
KLM
Korean Air
LATAM
Lufthansa
Qantas
Southwest Airlines
Turkish Airlines
United Airlines
Unlisted

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Alaskan Airlines *

British Airways *

Emirates *

Korean Air *

Lufthansa *

Southwest Airlines *

United Airlines *

American Airlines *

Delta Airlines *

KLM *

LATAM *

Qantas *

Turkish Airlines *

Unlisted *

Travel Party Details

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I am traveling as part of a team, group, or extended family member experience *

Yes
No

Main Contact's Name/Travel destination *

Agreement *

I have read and I accept both the agency's terms and conditions and their privacy policy and I consent to having this website store my submitted information so they can respond to my inquiry.

Agency Terms
Privacy Policy

Independently contracted with Travel Leaders/ Leone Travel Corp

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