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CALIF STATE TRAVEL
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Passenger Profile
Legal Passenger Name:
First/ Middle/Last needed
The name you enter must match the name on your driver’s license and passport.
Date of Birth
(mm/dd/yyyy)
Gender
Female
Male
Passport Number:
Exp. Date:
Country:
Place of Issue
(example US State Department or SFO Passport Agency)
Company Name:
Delivery Address:
Billing Address:
Contact numbers:
Work Contact:
Home:
Cell:
Pager:
Fax:
Email:
Credit Card number
(1st priority)
Exp. Date
Security Code
Billing Address for Credit Card
Credit Card number
(2nd priority)
Exp. Date
Security Code
Frequent Flyer Information
United #
American #
Delta #
Continental #
Northwest #
US Airways #
Other #
Airline Seating Preference
Aisle
Window
Hotel Preference
Preferred Hotel Chains:
Check All that Apply:
King
Two Double Beds
Suites
Smoking room
Non-smoking room
Lower Floors
Top Floors
Handicap room
Room service
Gym
On site restaurant
Other preferences
Hotel Corporate ID Numbers / Frequent Guest Numbers
Hilton
Marriott
Hyatt
Holiday Inn
Courtyard
Other
Car Preferences and ID Numbers/Frequent Guest Numbers: (Identify Preference)
Hertz
Avis
National
Hyatt
Budget
Courtyard
Other
(check all that apply)
Always book the lowest priced car rental company available
Major chains only
Rental counter must be located inside the airport
The chain must be one of my preferred companies
Car Type:
Luxury
4-Wheel drive
Mini Van
Full Size
Mid Size
Compact (four door)
Economy (two door)
Miscellaneous Information or requests: