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Your Information
*Title
Mr.
Mrs.
Ms.
Miss
Dr.
Prof.
Rev.
Other
*First Name (legal)
Middle Name (legal)
*Last Name (legal)
Company
Faculty / Department
*Home Address
*City
*Province Territory
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Northwest Territories
Saskatchewan
Yukon
*Postal Code
*Email
*Home Phone
Cell Phone
Company Address
*Business Phone
Emergency Contact Information
Full Name
Phone
On your Passport
DOB (MM-DD-YYYY)
Nationality
Passport Number
Passport Expiry
Spouse's Information
Title
Mr.
Mrs.
Ms.
Miss
Dr.
Prof.
Rev.
Other
First Name (legal)
Last Name (legal)
DOB (MM-DD-YYYY)
Frequent Flyer Information
Programs
Select a program
Air Canada Aeroplan
Aer Lingus Travel Award Bonus Program
Aerolineas Argentinas Plus Program
AeroMexico Club Premier
Air France Frequence Plus
Air New Zealand Air Points
Air Tran A Plus Rewards
Alaska Airlines Mileage Plan
Alitalia Club Mille Miglia
All Nippon Airways ANA Mileage Club
Aloha Airlines AlohaPass
America West FlightFund
American Airlines AAdvantage
Asiana Asiana Club
ATA Travel Awards
Austrian Airlines Miles & More
British Airways Executive Club
Cathay Pacific Airways Asia Miles
Continental OnePass
Delta Air Lines SkyMiles
EVA Evergreen Club
Finnair Plus Bonus Program
Frontier EarlyReturns
Hawaiian Airlines HawaiianMiles
Iberia Iberia Plus
Independence Air iClub
Japan Airlines JAL Mileage Bank
JetBlue TrueBlue
KLM Flying Dutchman
Korean Airlines Skypass
Latin Pass [now GlobalPass]
LOT Miles & More
Lufthansa Miles & More
Malaysia Airlines Enrich
Mexicana Frequenta
Midwest Airlines Midwest Miles
Northwest Airlines WorldPerks
Olympic Airways Icarus
Philippine Airlines Mabuhay Miles
Qantas Frequent Flyer
SAS EuroBonus
Singapore Airlines KrisFlyer
Southwest Airlines Rapid Rewards
Swiss TravelClub
TAP Air Portugal Navigator
United Airlines Mileage Plus
US Airways Dividend Miles
Varig Smiles
Virgin Atlantic Flying Club
Frequent Flyer Number
Hotel Loyalty Program
Programs
Select a program
Best Western, Gold Crown Club
Cendant (AmeriHost, Days Inn, Howard Johnson, Knights Inn, Ramada, Super 8, Travelodge, Villager, Wingate Inn) TripRewards
Hilton (Hilton, Conrad, Doubletree, Embassy Suites, Hampton Inn, Hilton Garden Inn, Homewood Suites, Scandic) HHonors
Hyatt Hotels & Resorts Hyatt Gold Passport
Inter-Continental (InterContinental, Crowne Plaza, Holiday Inn, Express by Holiday Inn, Staybridge Suites) Priority Club Rewards
Marriott (Marriott, JW Hotels, Renaissance, Courtyard, Residence Inn, Fairfield Inn, TownePlace Suites, SpringHill Suites, Ritz-Carlton, Ramada, ExecuStay) Marriott Rewards
Radisson (Radisson, Park Inn, Country Inns & Suites, Park Plaza, Regent International) Gold Rewards
Starwood (Westin, Sheraton, Four Points, St. Regis, Luxury Collection, W) Preferred Guest
Starwood (Westin, Sheraton, Four Points, St. Regis, Luxury Collection, W) Preferred Gues
Wyndham (Wyndham, Summerfield Suites) ByRequest
Plan Number:
Car Rental Reward Program
Programs
Select a program
Alamo Travel Partners
Avis Preferred Service
Budget Fastbreak
Dollar Rent A Car Travel Partners
Hertz #1 Club Gold
National Emerald Club
Thrifty Car Rental Blue Chip Rewards
Plan Number:
Other Preferences
Seating
None
Window
Aisle
Bulk Head
Meals
None
Bland
Child Meal
Diabetic
Fruit Platter
Gluten Free
Halal
High Fiber
Hindu
Kosher
Low Calorie
Low Fat/Cholesterol
Low Protein
Low Purine
Low Sodium
No Lactose
Oriental (Asian)
Raw Veggie/Fruit
Seafood
Vegetarian
Vegetarian (Asian)
Vegetarian (Pure)
Special Assistance
None
Blind
Deaf
Meet and Assist
Wheelchair - On-board Wheelchair
Wheelchair needed - cannot ascend/descend stairs
Wheelchair needed - can ascend/descend stairs
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