World Travel Bureau

World Travel Office Location
Name of Company / Organization
Name of Traveler, as it appears on your Passport or Drivers License
Mr./Mrs./Ms/Dr....
Business Title
Business Phone Number
Business Fax Number
Travel Planner:
Travel Planner Phone Number and Ext.
Travel Planner email address
Business Address
City, State, Zip
After hours / Cell Phone Number
Email address
Home Phone:
Home Address:
Home City, State, Zip
Annual Trips:
#1 Preferred Airline and Frequent Flyer Number
#2 Preferred Airline and Frequent Flyer Number
#3 Preferred Airline and Frequent Flyer Number
Class of Service, (First, Business, Coach, Economy):
Airline Seating Preferences (Window, Aisle):
Special Meals/Diet Requests:
Rental Car Company:
Rental Car Corporate ID #
Rental Car Personal ID #
Car Size (Compact, Midsize, Fullsize 2-door, Fullsize 4-door):
Rental Car Special Requests:
#1 Preferred Hotel & Corp. I.D. No.
#2 Preferred Hotel & Corp. I.D. No.
#3 Preferred Hotel & Corp. I.D. No.
Hotel Room Type (Smoking/ Nonsmoking):
Hotel Special Requests:
Credit Card Type:
Credit Card Number:
Credit Card Expiration Date
Name as it appears on Credit Card as well as Billing Mailing Address
Country of Citizenship
Passport Number:
Passport Issue Date:
Passport Expiration Date:
Favorite Place to Vacation:
Additional Information
For complete confidentaility and privacy, please print and fax this form to 714-835-8124.

� 1997 - 2003 World Travel Bureau Inc. CST # 1005049-10

Since 1938