Canada Travel Information
For Travel Agent - PLEASE FILL IN ONE FORM PER PERSON
Person Name ( Use this for for each traveller)
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other Travellers Name (Each person needs to do a seperate form but we need to match up)
First Name
Last Name
Do You have a current passport? ( your passport must expire 6 months after returning home)
Please Select
Yes I have a current Passport
Yes but I need to renew
No I need to apply for a passport
Full Traveller Name (as per Passport)
Date of Birth
-
Day
-
Month
Year
Date
Nationality
Please Select
Australian
Other -please fill in below
Nationality if not Australian
Passport Number
Passport Issuer
Passport Issue Date
-
Day
-
Month
Year
Date
Passport Expiry Date
-
Day
-
Month
Year
Date
Travel Insurance
Please Select
I Require Travel Insurance (please quote)
I have my own Travel Insurance (name below)
If Own Travel Insurance provide Provider and Policy #number
Emergency Contact Name
First Name
Last Name
Emergency Contact Relationship (eg. Sister)
Emergency Contact Email
example@example.com
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Mobility Issues
Dietary Requirements
Frequent Fly Numbers (eg. Qantas - 889000)
Will You Require Flights to and from Your Nearest Airport to Sydney ?
Please Select
Yes Please Contact Me
No I can arrange my travel to Sydney
Will You Require accomodation night (3rd August) prior to departure in Sydney on 4th ?
Please Select
Yes Please book me with the Group
No I don't need Accomodation
Any further Comments ( eg you would like to extend your stay and what are dates flights etc you require)
Car Hire ( We will need at least one person to be the primary Car Hirer) To be a car hirer you must have a Credit Card. You can let us know your willingness or not here
Please Select
Yes I have a credit card and willing to be a hirer
I would prefer not to be a car hirer
Signature
Submit
Should be Empty: