Travel Information Form

Traveler #1

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Traveler #2

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Email Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Other Travelers
Travel Date (Starting Approx.)

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Travel Date (Ending Approx.)

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Which Airport would you like to leave from?

Type of Trip: (please select all that applies)
Brief Description of Desired Location or Locations:

Other Services Needed: (please select all that applies)
Travel Agency Professional Service Fees

Vacations By CB LLC, the Host Agency, and/or its Independent Travel Advisors may charge professional service, planning, cancellation, research, or information fees based on the type, complexity, and time required for the travel services requested. The amount and applicability of any fee will be determined at the discretion of the Travel Advisor and/or Host Agency will be disclosed to the client prior to services being provided.

All applicable fees are due and payable in full upfront and are generally non-refundable once services have begun. At the discretion of Vacations By CB LLC and/or the Travel Advisor, a portion of the professional service fee may be applied as a credit toward the client's confirmed travel booking. Any such credit will be communicated to the client and is not guaranteed.

Cancellation fees may apply when a client requests the cancellation or significant modification of confirmed travel arrangements. These fees are separate from any cancellation of penalties, change of fees, or other charges imposed by airlines, cruise lines, resorts, tour operators, insurance providers, or other travel suppliers.
Information & Knowledgement

I agree that the information I have provided is correct and accurate. I agree to allow Highfill Travel, employee and/or Independent Contracted Travel Agent to look for trips/vacations, and email the information the client above.

Highfill Travel is and Independent Contracted Travel Agent, and thrives on building great vacations and creating a memorable travel experience that leaves you satisfied, but also eager to travel more. We take pride in our work and the satisfaction of all travelers.
Full Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
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