Client Form

Any travel agent can issue a ticket or book a cruise . . .
We create Travel Experiences . . . that extra effort is our hallmark!

In order to best fulfill your travel needs, a profile of information must be gathered in order to ensure that the correct information is given to the airlines, cruise companies or tour companies. Please take the time to fill this form out and return it or fax it to Your Travel Source. If you will be traveling with your passport, please make a copy of the name page from your passport and also send it with this form. If you are paying with your credit card, please make a copy of the front and back of the credit card and also attach it to this form. Thank you for your time as it makes our job so much easier to have the right information to give to the travel companies when making bookings for you.

PLEASE FILL OUT THIS FORM FOR EACH TRAVELER IF YOU HAVE DIFFERENT ADDRESSES AND ARE USING SEPARATE CREDIT CARDS.
THIS FORM IS ONLY FOR CLIENTS OF YOUR TRAVEL SOURCE

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GENERAL INFORMATION

Name(s) as they appear on the documentation you are going to use to travel with (passport or driver's license).

____________________   _____________________   ______________________     Birthdate: __________________
                    First                                Middle                                            Last

____________________   _____________________   ______________________     Birthdate: __________________
                    First                                Middle                                            Last
____________________   _____________________   ______________________     Birthdate: __________________
                    First                                Middle                                            Last

____________________   _____________________   ______________________     Birthdate: __________________
                    First                                Middle                                            Last

Address:_______________________________________   _______________________     ________ ______________
                                                                                                                                   City                                    State                  Zip
WPhone: (___)_______________ X_________ HPhone:(___)_________________ Fax:_(____)___________________

Cell Phones: _(___)____________________________________________Second Phone #: ( ___)_________________

E-mails:   __________________________________      ____________________________________________________

Best time to reach you: ____________________________________________________________________________ _
If anyone has different phone or fax numbers, please write them on the back of this form.   ============================================================================ ====================
CRUISE INFORMATION:

Anniversary: ________________ Dining:   Early q   Late   q           Bedding:   Queen q Twin   q

Special Requests (Wheelchair accessible room, et al): ______________________________________________________
____________________________________________________________________________ ____________________

EMERGENCY CONTACT INFORMATION

Emergency Contact: Name:______________________________________ Relationship: _________________________

Address (City, State, Zip): ______________________________________ HPhone:________________

WPhone: ___________________________   Cell Phone: ____________________________
If there are other emergency contact numbers, please write them on the back of this form.
============================================================================ ================
PASSPORT INFORMATION:

Surname (Last): ____________________ Given Name (First and middle Name):______________________

Passport #: _________________ Date of Birth: ____________ Sex: ___ Date of Issue: _________ Nationality: ________

Issued Where: __________ Date of Expiration: _____________________ Type of Passport: USA - Other _____________
-___________________________________________________________________________ _____________________
Surname (Last): ____________________ Given Name (First and middle Name):______________________

Passport #: _________________ Date of Birth: ____________ Sex: ___ Date of Issue: _________ Nationality: ________

Issued Where: __________ Date of Expiration: _____________________   Type of Passport:   USA - Other _____________
Please make sure that you attach the name page of your passports to this form.
============================================================================ ====================

Name on your Driver's License:___________ ____________________________________________________________

If you are using your driver's license as identification, the name on your airline ticket or tour vouchers must match your driver's license.   If you are cruising and do not have a passport, you must use your driver's license for boarding and you will also need your original birth certificate.
============================================================================ =====================
AIRLINE INFORMATION

What airlines do you prefer?__________________________________________________________________________

What airports do you prefer? #1_______________     #2_______________ #3_____________________

Frequent Flyer Numbers: ____________________________________________________________________________ _

____________________________________________________________________________ _____________________

Seat Request: Window q Aisle q Aisle and Aisle q Meal Requests:_____________________________________

Special Needs (Wheelchair, etc.) _______________________________________________________________________
==================================================================== ========CRUISE INFORMATION

Have you cruised before? If yes, then what cruise lines have you cruised on? _____________________________________

____________________________________________________________________________ _____________________
============================================================================ =====================
HOTEL INFORMATION

What type of hotels do you like to stay in? ________________________________________________________________

Are you a member of AAA or any other organization that would give you a discount? _______________________________

Special Requests: Smoking: q Nonsmoking: q Bedding Request: King: q Queen: q Twin: q
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------CAR RENTAL INFORMATION

Do you have a preference for a Car Rental Company? ________________________________________________________

Special Requests: Type of Car: Economy q Compact q Intermediate q Full-size q Specialty q
============================================================================ =====================
TRAVEL INFORMATION

Where have you traveled before? _______________________________________________________________________

____________________________________________________________________________ _____________________
What type of travel do you prefer? Cruising q Independent Travel q Escorted Tours q Adventure Travel q

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TRAVEL INSURANCE

In order to protect your investment plus protect yourself and you family while you are traveling cruise it is recommended that you seriously consider buying travel insurance. To learn more about travel insurance, please go to our website at http://www.yourtravelsource.com and click on Travel Insurance. Or call (800) 597-0594 for more information.

q I would like to purchase travel insurance q I choose not to purchase travel insurance q Please call me to discuss this. ============================================================================ ====================
DOCUMENTS

Please give me an address to send your documents. Preferrably it should be a location where the documents can be signed for. Documents are sent out via Airborne Express.

Send to: Company Name:______________________________________________________________________ ______

Address: ____________________________ City: ______________________ State: ______ Zip: ________________

Contact Name: _________________________________________________ Phone #: __________________________
============================================================================ ====================
CREDIT CARD INFORMATION:

Type of Credit Card: MC VI DI AX #: _______________________________________ VID: (3 digits) ___________

Exp. Date: _________________ Your name as it appears on your credit card: ___________________________________

Your billing address & phone number: ____________________________________________________________________________ ____________________
Address City State Zip Phone #:

Please fill out this form and include a copy of the name page of your passport(s) - the page that includes your fullname
and expiration date and send to Your Travel Source. Before sending, please read the Travel Consumer Restitution Corporation Disclosures below and make sure you check the line below.

q I have read and understand the TRCR Disclosures.

TRAVEL CONSUMER RESTITUTION CORPORATION (TCRC) DISCLOSURES

Your Travel Source is a participant in the Travel Consumers Restitution Corporation (TCRC). Registration as a seller of travel does not constitute approval by the State of California. California law requires certain sellers of travel to have a trust account or bond. This business has a trust account. Our CST# is: 2037874-40.

Right of California Customer to Make Claim on the California Restitution Fund

All payments for transportation or travel service not provided to the passenger shall be promptly refunded, in accordance with the agreed-to-terms and conditions, unless the passenger otherwise instructs the seller of travel in writing.

You, the passsenger, may request reimbursement from TCRC if you are owed a refund of more than $50 for transportation or travel services which was not refunded in a timely manner by a seller of travel who was registered and participating in the TCRC at the time of sale. The maximum amount which may be paid by the TCRC to any one passenger is the total amount paid on behalf of the passenger to the seller of travel, not to exceed $15,000.

A claim must be submitted to the TCRC within six months after the scheduled completion date of the travel. A claim must include sufficient information and documentation to prove your claim and a $35 processing fee. You must agree to waive your right to other civil remedies against a registered participating seller of travel for matters arising out of a sale for which you file a claim with the TCRC, if you were located in California at the time of the sale. You may request a claim form by writing to : Travel Consumer Restitution Corporation, P.O. Box 6001, Larkspur, CA 94977-600l; or by faxing a request to: (415) 927-7698.

Customers Located Outside of California

This transaction is not covered by the California Travel Consumer Restitution Fund. You are not eligible to file a claim against that Fund in the event of this Travel Agency's default.

For more information please contact:
YOUR TRAVEL SOURCE
Chris Meny, ACC, Stevie Ryer, Chris Lindstrom, Donna Collins Beauchesne, CTC, MCC
2923 Carmel Way ¨ Fairfield, CA   94534-1712
(707) 425-8157   ¨ (800) 597-0594
CST: 2037874-40
chris@yourtravelsource.com ¨ stevie@yourtravelsource.com,
donnab@yourtravelsource.com    clindstrom3036@yahooLindstrom.com
http://www.yourtravelsource.com
Aussie Specialists ¨ New Zealand Kiwi Specialists ¨ Hawaii Destination Specialists
Tahiti Tiare Specialists ¨ Cook Island Specialists ¨ Matai Fiji Islands Specialist ¨ Shamrock Ireland Specialists
¨ Singapore Specialists¨ Scotland Specialists ¨ South Africa Specialist

WE SELL THE WORLD TO OUR CLIENTS

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