Your Travel Broker Travellers Info Form

Travellers Information Form

Thank you for filling out the Travellers Information Form. Please note all information supplied will be held in confidence. We will disclose only the information necessary to fulfill documentation requirements or to facilitate your travel arrangements. It is very important this form is filled out with all the correct information. If incorrect information is provided, airline and agency amendment fees will apply.

* Indicates required field

Name as in Passport (VERY IMPORTANT!) *

First

Last

Postal Address (Including Postcode) *

Email *

Phone Number *

Mobile Number *

Date of Birth *

Details of the passport you will be travelling with:

Nationality of Passport *

Passport Number *

Date of Issue *

Date of Expiry *

Place of Birth *

If not on NZ Passport, Do you have a Returning Resident Visa? *

YES NO

Airline Frequent Flyers (eg. Airpoints etc)

Name of Airline *

Any pre-existing medical conditions *

Any criminal convictions (restrictions may apply) *

Special seating / meal requirements *

Any special requests *

Membership/Frequent Flyer Number *

Pin Number/Passwords *

Name of Airline *

Membership/Frequent Flyer Number *

Pin Number/Passwords *

Please complete and submit this form for each traveller

Submit