CAPITOL TRAVEL "VIP" PROFILE

This information will be used to create an individual personalized file in our reservations system, eliminating the need to repeat your information with each reservation.  This enhancement will assure that the frequent traveler's needs are fulfilled with greater speed and accuracy.  
 This information is private and will not be shared with anyone.

Name (as it appears on government issued ID)

Date of Birth (mm/dd/yyyy)  REQUIRED BY SECURE FLIGHT RULES

Gender:     Male        Female      REQUIRED BY SECURE FLIGHT RULES

Title/Dept.

Company


Street Address

City/State/Zip

Work Telephone

Assistant's Name

Airline Preferences

Seat Preference:

Window     

Aisle       

Car Rental Preferred Numbers

Hotel Preferred Numbers

Other Discount Numbers

Frequent Flyer Numbers                               Airline
Passport Number
Issuing Country
Issuing City 
Date of Issue (mm/dd/yyyy) 
Date of Expiration (mm/dd/yyyy)
Home Address

City/State/Zip 

Home Phone

Cell Phone

Fax

Email

Remarks

Credit Cards - Please Indicate if
Personal or Corporate

American Express #

Expiration Date 
Personal         Corporate   

MasterCard  # 

Expiration Date 
Personal         Corporate   

Visa #

Expiration Date 
Personal         Corporate   

Other #'s and Dates

Personal         Corporate   


Personal         Corporate   


Personal         Corporate   


Personal         Corporate   

Specific Billing or Ticketing Instructions

Additional Miscellaneous Information