Traveler S Profile

TRAVELER’S PROFILE

Title Last Name First Name MI Gender DOB (mm/dd/yy) Select One M F

Employee Number Phone Number Business Unit Cell Number Email Fax Number WORK ADDRESS TRAVEL ARRANGER INFORMATION Street Travel Arranger City, State, Zip Arranger Phone TRA Approval by Arranger Email CREDIT CARD FOR BUSINESS TRAVEL Card Account Number Expiration Select One Select One PERSONAL INFORMATION Home Address Home Phone City, State, Zip Home Email Emergency Contact TRAVEL INFORMATION Airport Preference Special Meal Preference (Low fat, low sodium, diabetic, etc.) Class and Seating Preference Select One / Select One Medical Alert (Please Specify INTERNATIONAL TRAVEL INFORMATION Passport Number Countries Frequent Expiration Date Visa # (non-U.S. Citizen) FREQUENT FLYER ACCOUNTS Airline Account # Airline Account #

CAR – FREQUENT RENTER ACCOUNTS Select Car Type Rental Agency Account # Rental Agency Account # Avis Wizard National Green Light Budget Super Rez Alamo Hertz Number 1 Other HOTEL – FREQUENT STAY ACCOUNTS Select One Hotel Account # Hotel Account #

PLEASE RETURN FORM VIA EMAIL OR FAX TO YOUR ASSIGNED OT&T TRAVEL OFFICE