HOURS:
Monday through Friday:
8:30 AM to 5:00 PM
Mailing Address:
Durgan Travel Service
125 Main Street
Stoneham, MA 02180
Site Menu
Site Menu
Your E-mail Address:
Tour/Cruise Registration
Tour or Cruise Line/Ship Title:
*
Tour/Cruise Departure Date:
Group/Group Leader Name or Durgan Travel (Individual Client):
Cruise Cabin Category (if applicable):
Please give the name of the trip as it appears on your flyer, if possible.
Full Legal Passport Name
PLEASE ENSURE THAT ALL NAMES ARE FILLED IN AS THEY APPEAR ON PASSPORTS. The Transportation Security Administration (TSA) requires the following information: You are responsible for filling out this form correctly and completely, and failure to do so will result in the denial of boarding at the airport and/or financial penalties (upwards of $125). You are responsible for any expenses, inconveniences, or loss of trip stemming from providing incomplete or incorrect information. Additionally, airlines are refusing to do “name changes” if information is not provided properly in the first place, resulting in the passenger losing their seat. Any missing or outdated information MUST be provided to Durgan Travel no later than 75 days prior to departure. Plan to renew your passport in time to submit all pertinent information by 75 days prior to departure. Your passport must be good for a minimum of six (6) months after your return date.
First Name:
*
Middle Name:
Last Name:
*
Billing Address
Street:
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City:
*
State:
*
Zip Code:
*
Phone Numbers
Home Phone Number:
*
Cell Phone Number:
*
Emergency Contact
Name:
*
Relation:
*
Phone Number:
*
Personal Information
Date of Birth:
*
Gender:
*
Passport Information
Passport Image/Scan:
Note: Please make sure you’ve taken a clear, complete scan of your passport's identification page which legibly displays ALL information (i.e. name, date of birth, etc.).
Passport Number:
Date of Issuance:
Expiration Date:
Country of Issuance:
Passport: Please check one of the below:
Uploaded
Will Email
Will Mail Copy
Applying
Renewing
*Email: billing@durgantravel.com
Electronic Correspondence
Email Address for Billing:
*
Email Address for Traveler:
*
Rooming/Roommates:
Single Room (Note single supplement on trip flyer)
Double Twin Room (2 Twin Beds)
Double Full Room (1 Full Bed)
Roommate:
If you have a preferred roommate, please list their name in the box above. Please note that it is the responsibility of the individual traveler or the group organizer to procure a roommate; however, you may still register for the tour if your roommate is unknown at this time.
Dietary Requests:
*
(i.e. vegetarian, gluten free, allergies, etc.)
Additional Comments/Requests:
As the discretion of honoring seating requests lies entirely with the airline, we cannot guarantee seating requests. We are happy to receive them and submit them to the airline and hotel(s), and are assured that the airline/hotel(s) will attempt to fulfill them. All medical/dietary requests should be received no later than 30 days prior to departure. Actual seat assignments for group tours are given out upon check-in at the airport. There are no pre-assigned seating assignments short of paying fees for upgraded seating.
We offer Trip Mate Protection to insure your trip. Please see your trip flyer for cost details. Please choose yes or no:
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Yes, insure my trip with Trip Mate Travel Protection! Insurance will be added to
your
package, and will be prepaid from my deposit.
The insurance premium is non-refundable and non-transferable.
NO, I do not wish to include the premium for Trip Mate Travel Protection Insurance, and I realize that I am NOT covered by trip insurance.
I have read and understand the policies listed on my flyer. Prices on this flyer were effective on the date listed below. At the time you purchase your tour, prices may be higher because of an increase in carrier charges. Any rate changes would be advised at time of final billing. I understand that the airline tickets or air tours I am purchasing are subject to supplemental price increases after the date of purchase due to additional charges imposed by a supplier or government. I acknowledge that I may be charged additional sums by Durgan Travel to offset increased fees, fuel surcharges, taxes, fluctuation in foreign exchange markets or any combination thereof. I hereby consent to any post-purchase price increases and authorize Durgan Travel to charge my credit card for such additional amounts. Additionally, I have provided all information as accurately as possible and with the understanding that I may be subject to a cancellation or change penalties of at least $125 if they are incorrect.
Choose Payment Method:
*
Mailing Check
Contact Durgan for Payment
Signature:
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Date of Signature:
*
Please click here if you accept the above conditions:
*
I have read and understand the policies listed on my flyer, etc.
