Corporate Traveler Profile
Member Information
Individual’s Name: Date:
Company: Administrative Contact:
Address:
Work Phone: Work Fax: Email:
Passport Information
Passport Country Passport Number
DOB (for security purposes)
Passport Issue Date Passport Expiration Date
Family Information
Home Address:
Spouse’s Name: Children(s) Names:
Home Phone: Home Email:
Leisure Travel Information
1. How often do you travel? (trips per year) Business Leisure
2. Where are you interested in traveling?
3. Which types of travel interest you?
Cruise Exotic Tour Independent Resorts Beach Sports / Adventure
4. Which tour/cruise companies have you traveled with in the past?
5. Activities of interest while on vacation: (Please check all that apply.)
Guided Tours Gourmet Dining Beaches Sightseeing Shopping Nightlife
Relaxing Meeting People Sporting Events Other:
6. How did you hear about this program?
Newspaper Yellow Pages Website Direct Mail Referral
7. How do you want us to communicate specials with you?
Fax E-mail Direct Mail Phone
Car Rental Information
Car Size: Luxury Full-size Mid-side Compact Other
Rental Car Company Name: Membership Number:
Rental Car Company Name: Membership Number:
Financial Information
For Airline Tickets:
Type of Card Number Exp.
For Hotels:
Type of Card Number Exp.
Preferences
Ticket Class First Business Lowest Fare
Seating Preference Aisle Window Front Bulkhead
Meal Preference Vegetarian Kosher Low Cal Seafood
Special Medical Needs/Alerts
Frequent Flyer Information
American# Name on Card Card Type
Continental # Name on Card Card Type
Delta # Name on Card Card Type
Northwest # Name on Card Card Type
United # Name on Card Card Type
US Airways# Name on Card Card Type
Other # Name on Card Card Type
Hotel Information
Type of Room: Non-Smoking Smoking No Preference
Lower Floor Concierge Level
Memberships:
Hotel Name Member Number
Hotel Name Member Number
Hotel Name Member Number
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To be Completed by a Putman Travel Representative
Entered By: Member Type:
Account Number: All-Inclusive Corp. Select
V3 5-17-02