MGB Center For Global Health

MGB Center For Global Health
Traveler & Department Information
Billing Business Unit
Cost Center/Fund Number
CGH Fund Managers
CGH Fund Manager Email
MGB Submitter Name (if applicable)
MGB Submitter Email (if applicable)
MGB email address
Do Federal Travel Restrictions Apply? (ex. Fly America Act)
Please provide documentation for exceptions.

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Traveler Name and Contact Information

The following information is required for TSA compliance, Great Getaways internal records, reservations ticketing, and MGB Risk Management.
Last Name* /First Name* Middle Name
Traveler Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Business Email
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
International Travel & Passport Details
Are you traveling internationally?
Passport Name

First NameMiddle NameLast Name
Passport Document Number
Passport Issuing Country
Passport Expiry Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Nationality
Gender
TSA Pre / Known Traveler Number (KTN) / GOES
Redress Control Number
Membership Numbers
Do you have membership numbers?
AAA Membership Number
American Airlines Frequent Flyer Number
Delta Frequent Flyer Number
JetBlue Frequent Flyer Number
United Frequent Flyer Number
Southwest Frequent Flyer Number
British Airways Frequent Flyer Number
Other Frequent Flyer Number
Please include Airline Name
Other Frequent Flyer Number 2
Marriott Bonvoy Hotel Membership Number
Hilton Hotel Membership Number
Hyatt Hotel Membership Number
Priority Club Hotel Membership Number
Other Hotel Membership Number 1
Hertz Car Rental Membership Number
Enterprise Car Rental Membership Number
Travel Request Details
Do you have a Travel Request?
Departure City
Arrival City
Departure Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred Departure Time

Hour Minutes

AM/PM Option
Return Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred Return Time

Hour Minutes

AM/PM Option
Seating Preference
Accessibility, special needs requirements, air and hotel preferences, and requests
Do you need multiple destinations?
Multi-Destinations
Other Flight Details
Do you require accommodations?
Number of Rooms
Room/Bedding Type
Preferred Hotel Brand
Special Requests (hotel)
Do you require a car rental?
Preferred Car Rental
Do you require train/rail?
Preferred Train Car Class
Anything else you’d like us to know?
Is your travel part of a group trip?
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Location
Number of Travelers
Are other services needed?
Please describe other services
Companion Traveler Details
Is there a companion traveler?
Companion Traveler Name

First NameMiddle NameLast Name
Companion Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Companion Gender
Companion Traveler Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Companion Email
example@example.com
Companion GOES/TSA Pre-Check/Known Traveler Number
Companion Frequent Flyer Numbers
Companion Special Needs/requests
Terms, Signature & Verification
Terms & Conditions Acknowledgement

During the process of providing travel services, Great Getaways may collect, store, and transmit your personally identifiable information such as name, address, contact information, preferences, demographic information, as well as any hotel or travel requests you provide us. This information is necessary for the facilitation of your travel reservation. This information may be shared with other 3rd parties, such as event organizers, planners, affiliated organizations, and travel and lodging providers. Should you wish to manage the information entrusted to Great Getaways, you can by contacting us via mgbtravel@ggatravel.com

Travelers and arrangers are responsible for complying with the travel policy of their MGB Institution, Department, and Grant(s) as well as government rules and regulation
I agree to terms & conditions
Signature
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MGB Center For Global Health

Traveler & Department Information

Traveler Name and Contact Information

International Travel & Passport Details

Membership Numbers

Travel Request Details

Companion Traveler Details

Terms, Signature & Verification