Booking and Confirmation Form
Please Note that this form must be filled out for each Traveller
Number Of Travellers In Party
*
1
2
3
4
5
6
Preferred Bedding/Sleeping Arrangements: (i.e Twin, Queen, Single)
Please note if you do not have current passport or drivers license details please use the current date and TBA as answers for the form
Passenger 1
General Details
Name
*
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
The agent I am working with is ..
*
Daniel Spierings
Julie Woodall
Leonie Clay
Nathan Dimitrievich
Passport Details
If travelling domestically you can provide Drivers License Details, if Passport details pending please note as TBA and todays date
Date Of Birth
*
/
Day
/
Month
Year
Date
Passport Number
*
Alternately License Number
Date Of Passport Issue
*
/
Day
/
Month
Year
Alternately Date of License Issue
Date Of Passport Expiry
*
/
Day
/
Month
Year
Alternately Date of License Expiry
Place Of Birth
*
Include Country if not in Australia
Citizenship / Nationality
*
Country Of Passport issuance
Extra Details
Extra Services
*
Yes
No
I would like to receive information on Travel Insurance
I would like to receive information on Airport Transfers
I would like to receive information on Foreign Exchange
Special Requirements
*
Yes
No
I have Special Dietary Requirements
I have Special Medical Requirements
I have Special Mobility Requirements
Please Provide details of answer is "Yes" to any special requirements
Emergency Contact Details
This must be a contact who is NOT Travelling with you!
Emergency Contact Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship to Traveller
*
Frequent Traveller Details
Frequent Flyer Number & Airline
Cruise Member Number & Cruise Line
Passenger 2
General Details
Name
*
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
The agent I am working with is ..
*
Daniel Spierings
Julie Woodall
Leonie Clay
Nathan Dimitrievich
Passport Details
If travelling domestically you can provide Drivers License Details, if Passport details pending please note as TBA and todays date
Date Of Birth
*
/
Day
/
Month
Year
Date
Passport Number
*
Alternately License Number
Date Of Passport Issue
*
/
Day
/
Month
Year
Alternately Date of License Issue
Date Of Passport Expiry
*
/
Day
/
Month
Year
Alternately Date of License Expiry
Place Of Birth
*
Include Country if not in Australia
Citizenship / Nationality
*
Country Of Passport issuance
Extra Details
Extra Services
*
Yes
No
I would like to receive information on Travel Insurance
I would like to receive information on Airport Transfers
I would like to receive information on Foreign Exchange
Special Requirements
*
Yes
No
I have Special Dietary Requirements
I have Special Medical Requirements
I have Special Mobility Requirements
Please Provide details of answer is "Yes" to any special requirements
Emergency Contact Details
This must be a contact who is NOT Travelling with you!
Emergency Contact Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship to Traveller
*
Frequent Traveller Details
Frequent Flyer Number & Airline
Cruise Member Number & Cruise Line
Passenger 3
General Details
Name
*
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
The agent I am working with is ..
*
Daniel Spierings
Julie Woodall
Leonie Clay
Nathan Dimitrievich
Passport Details
If travelling domestically you can provide Drivers License Details, if Passport details pending please note as TBA and todays date
Date Of Birth
*
/
Day
/
Month
Year
Date
Passport Number
*
Alternately License Number
Date Of Passport Issue
*
/
Day
/
Month
Year
Alternately Date of License Issue
Date Of Passport Expiry
*
/
Day
/
Month
Year
Alternately Date of License Expiry
Place Of Birth
*
Include Country if not in Australia
Citizenship / Nationality
*
Country Of Passport issuance
Extra Details
Extra Services
*
Yes
No
I would like to receive information on Travel Insurance
I would like to receive information on Airport Transfers
I would like to receive information on Foreign Exchange
Special Requirements
*
Yes
No
I have Special Dietary Requirements
I have Special Medical Requirements
I have Special Mobility Requirements
Please Provide details of answer is "Yes" to any special requirements
Emergency Contact Details
This must be a contact who is NOT Travelling with you!
Emergency Contact Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship to Traveller
*
Frequent Traveller Details
Frequent Flyer Number & Airline
Cruise Member Number & Cruise Line
Passenger 4
General Details
Name
*
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
The agent I am working with is ..
*
Daniel Spierings
Maree Wright
Meryl Sanchez
Julie Woodall
Leonie Clay
Cheree Miles
Passport Details
If travelling domestically you can provide Drivers License Details, if Passport details pending please note as TBA and todays date
Date Of Birth
*
/
Day
/
Month
Year
Date
Passport Number
*
Alternately License Number
Date Of Passport Issue
*
/
Day
/
Month
Year
Alternately Date of License Issue
Date Of Passport Expiry
*
/
Day
/
Month
Year
Alternately Date of License Expiry
Place Of Birth
*
Include Country if not in Australia
Citizenship / Nationality
*
Country Of Passport issuance
Extra Details
Extra Services
*
Yes
No
I would like to receive information on Travel Insurance
I would like to receive information on Airport Transfers
I would like to receive information on Foreign Exchange
Special Requirements
*
Yes
No
I have Special Dietary Requirements
I have Special Medical Requirements
I have Special Mobility Requirements
Please Provide details of answer is "Yes" to any special requirements
Emergency Contact Details
This must be a contact who is NOT Travelling with you!
Emergency Contact Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship to Traveller
*
Frequent Traveller Details
Frequent Flyer Number & Airline
Cruise Member Number & Cruise Line
Passenger 5
General Details
Name
*
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
The agent I am working with is ..
*
Daniel Spierings
Julie Woodall
Leonie Clay
Nathan Dimitrievich
Passport Details
If travelling domestically you can provide Drivers License Details, if Passport details pending please note as TBA and todays date
Date Of Birth
*
/
Day
/
Month
Year
Date
Passport Number
*
Alternately License Number
Date Of Passport Issue
*
/
Day
/
Month
Year
Alternately Date of License Issue
Date Of Passport Expiry
*
/
Day
/
Month
Year
Alternately Date of License Expiry
Place Of Birth
*
Include Country if not in Australia
Citizenship / Nationality
*
Country Of Passport issuance
Extra Details
Extra Services
*
Yes
No
I would like to receive information on Travel Insurance
I would like to receive information on Airport Transfers
I would like to receive information on Foreign Exchange
Special Requirements
*
Yes
No
I have Special Dietary Requirements
I have Special Medical Requirements
I have Special Mobility Requirements
Please Provide details of answer is "Yes" to any special requirements
Emergency Contact Details
This must be a contact who is NOT Travelling with you!
Emergency Contact Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship to Traveller
*
Frequent Traveller Details
Frequent Flyer Number & Airline
Cruise Member Number & Cruise Line
Passenger 6
General Details
Name
*
Mr.
Mrs.
Ms.
Miss.
Dr.
Prefix
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
The agent I am working with is ..
*
Daniel Spierings
Julie Woodall
Leonie Clay
Nathan Dimitrievich
Passport Details
If travelling domestically you can provide Drivers License Details, if Passport details pending please note as TBA and todays date
Date Of Birth
*
/
Day
/
Month
Year
Date
Passport Number
*
Alternately License Number
Date Of Passport Issue
*
/
Day
/
Month
Year
Alternately Date of License Issue
Date Of Passport Expiry
*
/
Day
/
Month
Year
Alternately Date of License Expiry
Place Of Birth
*
Include Country if not in Australia
Citizenship / Nationality
*
Country Of Passport issuance
Extra Details
Extra Services
*
Yes
No
I would like to receive information on Travel Insurance
I would like to receive information on Airport Transfers
I would like to receive information on Foreign Exchange
Special Requirements
*
Yes
No
I have Special Dietary Requirements
I have Special Medical Requirements
I have Special Mobility Requirements
Please Provide details of answer is "Yes" to any special requirements
Emergency Contact Details
This must be a contact who is NOT Travelling with you!
Emergency Contact Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship to Traveller
*
Frequent Traveller Details
Frequent Flyer Number & Airline
Cruise Member Number & Cruise Line
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Acceptance & Terms Of Service
I accept all terms and booking conditions which apply to my reservation by all service providers as well as those set forth by My Travel Expert and Shoalhaven Solo Sisters. We acknowledge that we have received a privacy statement and terms and conditions and we acknowledge that our contact details may be used by My Travel Expert for marketing and research purposes. We acknowledge that all the details given above are correct at the time of booking and will advise My Travel Expert of any changes in timely fashion. We understand that My Travel expert respects our privacy and understand that all information provided on this booking form will be treated in accordance with the Privacy Act, and barring details that need to be passed along to service providers all details shall remain confidential
*
Yes
I have read all the terms and conditions as applicable for My Travel Expert and acknowledge the terms and conditions laid out by their airline, hotel, tour operator and travel industry partners
*
Yes
I acknowledge that by filling out this form and providing any payment that all details we have provided to My Travel Expert is correct
*
Yes
I acknowledge that by filling out this form and providing any payment that all details provided to me by My Travel Expert for Travel arrangements are correct and booked as requested
*
Yes
I consent to My Travel Expert, Helloworld Limited, and its associated entities sending me marketing material, including via electronic messages, relating to their and their partners' products and services that may be of interest to me, and to My Travel Expert disclosing my personal information to Helloworld Limited for this purpose.
*
Yes
No
I understand that Global Travel Conditions due to COVID-19 are currently in flux, and that changes can occur in an instant without notice. I understand that these changes can cause bookings and travel arrangements to be delayed, rescheduled or suspended and that these changed can cost in some cases significant amounts. I also understand that these changes are due to global circumstances beyond the ability of My Travel Expert to control and understand that they can not be held responsible for any additional costs or expenses in relation to changes due to the COVID-19 Pandemic
*
Yes
Signed
*
Date
*
/
Day
/
Month
Year
Date
Submit
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