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Meet Larry
Porterra Travel - A different kind of travel company
Please fill this form out completely if you have space confirmed on one of our trips... And get ready for some fun!!!
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Which trip are you registered for?
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Passport Information.
First Name as it appears on your passport
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It is important that your name on your ticket matches exactly with your name on your passport
Middle name or initial as it appears on your passport
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Fill this field out only if your middle name or initial appears on your passport.
Last Name as it appears on your passport
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Your name on your ticket must match exactly with your name 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
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MM-DD-YYYY
Gender
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Male
Female
Place of birth - City, State, Country
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By what country is your passport issued?
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For most this will be USA.
Passport Number
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Please submit your passport number.
Passport Expiration Date
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MM-DD-YYYY
Your passport must be valid for at least six months beyond our departure date.
Your information.
Your Address
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Line 1
Line 2
City
State
Zip Code
Country
Primary Phone Number
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Other phone Number
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Email
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What is your occupation?
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Do you have any dietary restrictions?
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Known Traveler Number/Global Entry ID if applicable
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Rooming information.
Are you traveling solo or rooming with someone?
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Solo
Rooming with someone
If you are rooming with someone, who?
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Room requirements
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1 bed (for a couple)
2 beds (two singles)
Do you smoke?
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Yes
No
Emergency Contact
Emergency contact name
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Emergency contact Phone Number
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Travel Insurance
Choose One
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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.
I have already purchased travel insurance
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.
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I agree.
Comments or Questions
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Porterra Travel 155 Parker Avenue Easton, PA 18042 610-390-0502 PorterraTravel@gmail.com
