Travel Request Form

Ragon Visitor Travel Request

Amy Tan -- ATAN6@mgh.harvard.edu -- Ragon Institute of MGH, MIT and Harvard
Department Name*
Cost Center*
Travel Arranger (if not traveler)

First NameLast Name
Travel Arranger Phone
Area code and number
Travel Arranger Email Address
TRAVELER INFORMATION

The following information is required for TSA compliance, Great Getaways internal records, reservation ticketing, and MGB Risk Management.
Last Name* / First Name* Middle Name
Traveler Mobile Phone Number *
Area code and number
Email Address*
- Birth Date*
  
  MonthDayYear
- Gender (as it appears on your Passport or Government Issued ID)*
  Gender must match Government ID
- TSA Pre✔ Known Traveler Number (KTN) GOES
- Redress Control Number (redress number)
- Departure City*
  *Please list departure city/airport
- Depature Date and Time *
  
  MonthDayYear
  DateHourMinutesAM/PM Option
- Arrival/Departure City*
- Return Date and Time *
  
  MonthDayYear
  DateHourMinutesAM/PM Option
- Aisle SeatWindow SeatNo preference
- Accessibility, special needs requirements, air and hotel preferences, and requests?
  *Please list any special needs requests or preferences
- More-Leg Room SeatingUpgrade to Business ClassUpgrade to First ClassWould like to know the options on a trip by trip basis
- Other Details:
- YesNo
- FREQUENT FLYER NUMBERS
- American Airlines
  *If you have a frequent flyer account, please list here.
- Delta Airlines
  *If you have a frequent flyer account, please list here.
- JetBlue
  *If you have a frequent flyer account, please list here.
- United Airlines
  *If you have a frequent flyer account, please list here.
- Southwest Airlines
  *If you have a frequent flyer account, please list here.
- Frequent Flyer other
  *If you have a frequent flyer account, please list here.
- Anything else you'd like us to know?
  *Please indicate any other travel needs, details, health concerns or special requests for this trip.
- At Great Getaways, we are committed to safeguarding your personal information and ensuring your privacy. In the course of providing our travel services, we may collect, store, and transmit personally identifiable information, including but not limited to your name, address, contact details, preferences, demographic data, and any specific hotel or travel requests you provide. This information is essential for facilitating your travel reservations.
  
  To deliver our services effectively, your information may be shared with third parties, such as event organizers, planners, affiliated organizations, and travel and lodging providers. We only share the necessary information required to complete your bookings and fulfill your travel needs. Additionally, a copy of your booking will be provided to MGB and may be transmitted to a designated vendor responsible for fulfilling duty of care obligations.
  
  If you wish to review, update, or manage the information you have entrusted to Great Getaways, please contact us at mgbtravel@ggatravel.com.
  
  Please note that travelers and travel arrangers are responsible for adhering to the travel policies of their MGB Institution, Department, and any relevant Grants, as well as complying with all applicable government rules and regulations.
- Click the Box*
- Should be Empty:

Ragon Visitor Travel Request