TRAVEL-ON: Travel Request Form

OANDP Travel Request

An agent will contact you to discuss your reservations within 24 hours, between 8:30 am - 5:00 pm (EST) Monday through Friday.

Fields with * are mandatory.

CONTACT INFORMATION
* Travel request submitted by:
* Company:
* Your Name:		* Email:
* Phone:		Fax:

TRAVELER INFORMATION
* Full Name (as it appears on the govt. issued ID)	* Date of Birth	Gender	Airline Frequent Flyer #	Seat Preference
		Male Female		Window Aisle
		Male Female		Window Aisle
Note: Please list additional travelers in the "Remaks" field below with their full names, dates of birth, and genders.

AIRLINE RESERVATIONS * Please list the most critical time - Arrival OR Departure.
NOTE: An electronic ticket will be issued when available. If a paper ticket is requested when an electronic ticket is available, there will be an airline imposed fee of up to $50.00 (USD) per ticket and the fee is subject to change at any time. When a paper ticket is mandated by the airline, no additional fee applies.
* Departure Date	Depart by (i.e. 7:00am)	OR	Arrive by (i.e. 9:30am)	* From (City/Airport)	* To (City/Airport)	Preferred Airline or Flight # (if known)
		OR
		OR
		OR
		OR

Will accept connecting flights for lower fares: Yes \| No
Will accept non-refundable airlines if available/applicable: Yes \| No
Additional requirements:

EMERGENCY CONTACT INFORMATION (Required by Airlines)
Name:		Phone:		Relationship:

CREDIT CARD INFORMATION
Credit Card Type	Credit Card #	Exp. Date (MM/YY)	Name on Card


The traveler and their company hereby authorize Travel-On to charge to the business and/or personal credit card account(s) as indicated on this form, any travel transactions requested by the traveler or their authorized agent via telephone, e-mail, fax, and web site.

REMARKS

A confirmation copy of the form submitted will be returned to your screen
within 2 - 3 seconds after you press "Send Request".
Please print for your records.