PARNESSE TRAVELS QUESTIONNAIRE
PERSONAL INFORMATION
Surname/First Name/Middle Name *
(Name of the Traveller as in your passport)
Your answer
Address
Your answer
City
Your answer
State
Your answer
Email
Your answer
Home Phone
Your answer
Work Phone
Your answer
Mobile Phone
Your answer
Occupation
Your answer
Organisation
Your answer
Age
Citizenship
Your answer
TRAVEL PLAN
Place of residence
Your answer
Travel Destination
Your answer
Expected date of departure (MM/DD/YY)
MM
/
DD
/
YYYY
Expected Return Date (MM/DD/YY)
MM
/
DD
/
YYYY
Reason For Travel
Q1. Where will you stay? (Tick one) The kind of accommodation you wish us to book for you
Q2. What type of accommodation would you like us to book for you?
If Hotel, It is
Q3. Please Specify What will be the total duration of your journey?
City & Country
Your answer
Length of stay
Your answer
Date of return
MM
/
DD
/
YYYY
Prefered travel day
Are you able to be flexible with your travel dates?
Q4: Mention the name & details of the airline via which you are going to travel?
Prefered Travel Class
If not Available
Frequent traveler membership details:
Airline
Your answer
CARD NO. {type not necessary}
Your answer
Q5: What will be the total no. of persons with you for the journey?
Select Category
Q6: What are the ages of the travelers in your group?
(select all that applies)
Q7: Are you planning for insurance for all the travelers?
Please provide the names of persons, their ages & type of insurance
Your answer
Q8: Has any of the travelers been hospitalized during the last 6 months?
If Yes (pls provide details)
Your answer
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