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IP TRAVEL

Travel Request Information

Passenger Contact Infos

MrMrsMiss

SeniorChild

Last name:

First name:

Purchase Order:

Email:

Birthday:

Mobile:

Flight Reservation

Trip #1

Travel Dates & Time:

From :

To :

Airline company :

Reservation Class :

EconomyEconomy PremiumBusinessFirst

Checked Luggages :

YesNo

Trip #2

Travel Dates & Time:

From :

To :

Airline company :

Reservation Class :

EconomyEconomy PremiumBusinessFirst

Checked Luggages :

YesNo

Trip #3

Travel Dates & Time:

From :

To :

Airline company :

Reservation Class :

EconomyEconomy PremiumBusinessFirst

Checked Luggages :

YesNo

Other info

Frequent Flyer Number #1 :

Frequent Flyer Number #2 :

Train Reservation

Trip #1

Travel Dates & Time:

From :

To :

Reservation Class :

First ClassSecond Class

Reservation Method :

No FlexMid FlexFull Flex

Trip #2

Travel Dates & Time:

From :

To :

Reservation Class :

First ClassSecond Class

Reservation Method :

No FlexMid FlexFull Flex

Trip #3

Travel Dates & Time:

From :

To :

Reservation Class :

First ClassSecond Class

Reservation Method :

No FlexMid FlexFull Flex

Hotel Reservation

I want IpTravel to book a Hotel for me?
YesNo

Hotel #1

Travel Dates:

Check in:

Check Out:

Hotel Name:

Hôtel Category :

Adress:

Hotel #2

Travel Dates:

Check in:

Check Out:

Hotel Name:

Hôtel Category :

Adress:

Car Reservation

I want IpTravel to book a car for me?
YesNo

Car Infos

Travel Dates & Time:

Pick up:

Drop Off:

Type of car :

Gearbox

ManualAutomatic

Car rental company :

Card/Contract number :

Transfers

Travel Dates & Time

Go:

Return:

From :

To :

Others

Boarding Passes:

YESNO

Remarks:

Visa

I would like IP Travel manage my visa request :

YESNO

IP Travel . 10 Avenue du Parc, 1060 Bruxelles . Tel : +32 2 340 08 08 . Fax : +32 2 344 26 60 . email : info@iptravel.be

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