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Client Services > Personal Profiles

(All information you provide to us is treated as secure data for your protection.)

Business Information:

Company Name:

Address:

City:

State:

Zip Code:

Phone Number:

Web Site Address:

Personal Information:

Name: (exactly as it appears on driver's license)

Address:

City:

State:

Zip Code:

Date of Birth:

Home Phone:

Fax Number:

Email Address:

Airline Information:

Airline Frequent Flyer Numbers:

Seat Preference:
Aisle Window

Other special requests:

Hotel Information:

Hotel Club Numbers:

Room Type Preference:
Smoking Non-Smoking
Double King

Other special requests:

Car Information:

Car Rental ID Numbers:


    Please check here if you are under the age of 25.

Car Size Preference:
Compact Midsize Full Size 2-DR Full Size 4-DR

Other special requests:

Billing Information:

Business Credit Card: (credit card where all air tickets are to be billed)

Expiration Date:

Billing Code and/or additional instructions:

CREDIT CARDS - Although your form of payment may not be by a major credit card, many hotels and car rental companies require a major credit card to guarantee late arrival or to eliminate cash deposits on check-in. Having this information in our files will permit us to make these guarantees with your approval without the delay of asking you for the information on each booking.

Personal Credit Card: (for hotel/car rental guarantees)

Expiration Date:

Billing Code and/or additional instructions:

By completing and submitting this form, you are authorizing Accent Travel to charge travel arrangements to your account.

If you are concerned about the security of online submission of credit card numbers,
please call Accent Travel directly at 952-854-4440 after you have submitted this form.

P. 952-854-4440 · F. 952-854-1767 · E. info@accenttravelintl.com

ASTA - The American Society of Travel Agents

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