Submit Passport Info

Please fill this form out completely if you have space confirmed on one of our trips... And get ready for some fun!!!

* Indicates required field

Which trip are you registered for? *

Passport Information.

First Name as it appears on your passport *

Middle name or initial as it appears on your passport *

Last Name as it appears on your passport *

It is important that you submit your name exactly as it appears on your passport. Incorrectly submitted names may be subject to airline reticketing fees.

Date of Birth *

Gender *

Male Female

Place of birth - City, State, Country *

By what country is your passport issued? *

Passport Number *

Passport Expiration Date *

Your passport must be valid for at least six months beyond our departure date.

Your information.

Your Address *

Line 1

Line 2

City

State

Zip Code

Country

Primary Phone Number *

Other phone Number *

Email *

What is your occupation? *

Do you have any dietary restrictions? *

Known Traveler Number/Global Entry ID if applicable *

Rooming information.

Are you traveling solo or rooming with someone? *

Solo Rooming with someone

If you are rooming with someone, who? *

Room requirements *

1 bed (for a couple) 2 beds (two singles)

Do you smoke? *

Emergency Contact

Emergency contact name *

Emergency contact Phone Number *

Travel Insurance

Choose One *

I would like a quote to purchase Travelguard travel insurance. I have been offered the opportunity to purchase travel insurance and have elected to decline.

Required Documents.

In order to submit your registration you must read and agree to our terms and conditions available for review and download at the bottom of this page.

I have read and agree to the terms and conditions of this trip. *

I agree.

Comments or Questions *

Submit

porterra_travel_t_c_2021-2-2.pdf
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File Type:	pdf

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Porterra Travel 155 Parker Avenue Easton, PA 18042 610-390-0502 PorterraTravel@gmail.com