Traveler Profile Form Juneteenth’25

2025 Traveler Profile Form

DIASPORA TOURS is truly pleased to coordinate the plans for the "Juneteenth in Ghana 2025" experience! This is an 11-Day/10-Night pilgrimage beginning Monday, June 9 through Friday, June 20, 2025. Please complete this Traveler Profile Form to begin your reservation process. A separate form is required for each roommate. Upon submission, please confirm your seat on the tour by making your deposit or full payment. Contact Judiffier Pearson at jpearson@questfive.com if you have questions or need additional information.
Your Full Name- exactly as it appears on your passport*

PrefixFirst NameMiddle NameLast NameSuffix
Your Full Date of Birth*

MonthDayYear
Date
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your E-mail*
example@example.com
Your Cell Phone Number *

Area CodePhone Number
Do you have a passport?*

YesNo
If YES, Passport expiration date.
Passport Number
Hotel
List the number of Double Occupancy rooms you will need.
0
Double Occupancy Bed Preference

KingTwin Beds
List the number of Single Occupancy rooms you will need.
0
Do you need any special hotel room accommodations?
Do you need any special accommodations (in general)? If so, please explain.
Roommate Information

This section needs to be completed for you and each of your roommates (adult and children).
Name 1*

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth*

MonthDayYear
Name 2

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name 3

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Name 4

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Total # of Adults in your room*
Total # of Children in your room
Are you interested in making one payment for the full cost of the trip via Zelle to avoid bankcard processing fees?
Are you interested in an installment plan? This requires you to enroll in an automatic payment schedule via credit/ debit card.
Are you interested in a payment plan shorter than 9 months? If so, please describe your preference in the "Additional Comments" section below.
Additional Comments
Should be Empty:

2025 Traveler Profile Form

Hotel

Roommate Information