Agency Profile Form

If you have already submitted a form and need to add or correct information, please do NOT use this form. Send an e-mail to online@duagency.com with the information and we will add it for you.

If you have Concur Travel - simply complete/update your online profile and the information will be shared with us automatically.

COMPANY OR ORGANIZATION NAME*

COMPANY LOCATION CITY*

Name (As it appears on your gov't issued ID)*

First NameMiddle NameLast Name

Department Number/Info (if applicable)

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Business E-mail*

Secondary E-mail (if desired)

example@example.com

Business Phone Number*

Area CodePhone Number

Cell Phone Number*

Area CodePhone Number

Birthdate (Airline ticket cannot be issued without this information)*

MonthDayYear

Gender (Airline ticket cannot be issued without this information)*

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number*

Area CodePhone Number

Relationship of Emergency Contact to Traveler?*

If Other:

Preferred Departure Airport*

Seat Preference

Meal Preference

TSA PreCheck (Trusted Traveler Number)

Passport Number

Passport Nationality

Passport Date of Issuance

MonthDayYear

Passport Date of Expiration

MonthDayYear

To ensure proper passport information - you can opt to upload a copy of your passport here.

Upload a File

Do you have Airline Frequent Flyer Numbers?

YesNo

FF #1 (Enter Airline and # separated by space or dash)*

FF #2 (Enter Airline and # separated by space or dash)

FF #3 (Enter Airline and # separated by space or dash)

Do you have more Airline Frequent Flyer Numbers to provide?

YesNo

FF #4 (Enter Airline and # separated by space or dash)*

FF #5 (Enter Airline and # separated by space or dash)

FF #6 (Enter Airline and # separated by space or dash)

Do you have more Airline Frequent Flyer Numbers to provide?

YesNo

FF #7 (Enter Airline and # separated by space or dash)*

FF #8 (Enter Airline and # separated by space or dash)

FF #9 (Enter Airline and # separated by space or dash)

FF #10 (Enter Airline and # separated by space or dash)

Air Reservation Special Requests

Car Size Preference

Do you have Car Loyalty Programs?

YesNo

Car Loyalty Program #1 (Enter Car Company and # separated by space or dash)*

Car Loyalty Program #2 (Enter Car Company and # separated by space or dash)

Car Loyalty Program #3 (Enter Car Company and # separated by space or dash)

Do you have more Car Loyalty Programs to provide?

YesNo

Car Loyalty Program #4 (Enter Car Company and # separated by space or dash)*

Car Loyalty Program #5 (Enter Car Company and # separated by space or dash)

Car Loyalty Program #6 (Enter Car Company and # separated by space or dash)

Car Rental Special Requests

Smoking Preference

SmokingNon-Smoking

Room Type Preference

King2 Queen or Double Beds

Do you need a handicap accessible room?

YesNo

Do you have Hotel Frequent Guest numbers?

YesNo

Hotel Frequent Guest #1 (Enter Hotel Chain and # separated by space or dash)*

Hotel Frequent Guest #2 (Enter Hotel Chain and # separated by space or dash)

Hotel Frequent Guest #3 (Enter Hotel Chain and # separated by space or dash)

Do you have more Hotel Frequent Guest numbers to provide?

YesNo

Hotel Frequent Guest #4 (Enter Hotel Chain and # separated by space or dash)*

Hotel Frequent Guest #5 (Enter Hotel Chain and # separated by space or dash)

Hotel Frequent Guest #6 (Enter Hotel Chain and # separated by space or dash)

Do you have more Hotel Frequent Guest numbers to provide?

YesNo

Hotel Frequent Guest #7 (Enter Hotel Chain and # separated by space or dash)*

Hotel Frequent Guest #8 (Enter Hotel Chain and # separated by space or dash)

Hotel Frequent Guest #9 (Enter Hotel Chain and # separated by space or dash)

Hotel Frequent Guest #10 (Enter Hotel Chain and # separated by space or dash)

Hotel Room Special Requests

Personal Information

Air Information

Car Rental Information

Hotel Information