Elán Travel - Traveler Information Form
Please complete one for each traveler. Information provided must match EXACTLY that on your official forms of identification and passport.
Name (as shown on passport or Real ID-compliant ID)
*
First and Middle Names
Last Name (Surname)
Suffix
Traveler’s Date of Birth
*
-
Month
-
Day
Year
Date
Traveler’s Place of Birth (city/state/country)
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Your Preferred Local Airport
Passport Place/Country of Issuance
Passport Date of Issuance
-
Month
-
Day
Year
Date
Passport Date of Expiration
-
Month
-
Day
Year
Date - Note that passport must be valid for at least six months from last date of expected international travel.
Known Traveler Number
Please attach a legible photo of your Passport ID page. Note that we require this information to ensure that we provide accurate information for airline and accommodation bookings.
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Airline Frequent Flyer Numbers (Name of airline and number)
Special Requests/Accommodations
Seat preferences, dietary restrictions, information regarding physical disabilities, etc.
Credit Card Information (Optional)
By providing this information you agree to the use of this card to charge fees and services booked by you through Elán Travel, LLC (Clearing through Direct Travel, Inc.). Please phone in with your credit card information, or contact us to obtain a link to submit that information through an encrypted link.
Name, as it appears on your credit card
First Name
Last Name
Billing address, if different than home address above
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
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