Upon Completion, Please Fax This Form To

GUEST INFORMATION FORM

Departure Date: Reservation ID: Vessel: AQ AE All Guests are required by the U.S. Department of Homeland Security and Coast Guard to complete this form on or before the final payment due date. Your travel documents cannot be released unless this form is fully completed. All information should be exactly as it appears on your government-issued photo identification. Please type or print clearly.

Travel Agency Name:

PASSENGER 1 PASSENGER 2 Last Name First Name Nick Name Email IDENTIFICATION

Type Driver’s License Passport Military Driver’s License Passport Military Other: Other: Place of Issue (State) ID Number Expiration Date Date of Issue Place of Birth (City, State) Place of Birth (Country) Date of Birth Citizenship Permanent Street Address City, State, Zip Telephone (Home): Telephone (Work): Telephone (Mobile):

EMERGENCY CONTACT INFORMATION Full Name of Contact Telephone # of Contact

SPECIAL REQUESTS

Will you be celebrating a special occasion with us? Yes No If so, please specify: Date Reason for Celebration:

Do you have any special dietary needs?

Should the vessel crew be made aware of any mobility issues or health concerns?

SECURE FORM SUBMISSION Upon completion, please fax this form to [email protected]

112415EL FAM