Travellers Information Form
* means required please


Surname:
As in Passport
*
 Mr Ms Mrs Miss Mstr
First Names:
As in Passport
*
Postal Address:
*
Post Code:
*
Find Post Code
Telephone:Day:
*
Evening
Fax: Mobile:
E-mail: *
Next Of Kin: Telephone (Work):
Telephone (Home):
Please record the details of the passport you will be travelling with:
Nationality of Passport: Passport Number:
Issued at: Expiry Date:
Passport Issue Date:
(dd/mm/yyyy)
 Date of Birth:
Place of birth:  
Do you have a NZ returning resident visa in your current passport?
(not for NZ or AU passport holders)		YesNo
Are there any mobility or health issues you wish to pass on to your transport/accommodation suppliers?YesNo
If yes please specify:
Do you have any special meal requirements?YesNo
If yes please specify:
Please note if you have any criminal convictions or communable diseases travel restrictions may apply.
Are you a member of a Airline frequent flyer programme?YesNo
Airline:Membership & Pin No:
Airline:Membership & Pin No:
*Please provide correct information as tickets will be issued against this. If incorrect information provided, airline and agency ammendment fees will apply All information supplied in this form will be held in confidence. We will disclose only that information necessarry to fulfil documentation requirements or to facilitate your travel arrangements.