BPL Travel Profile Submission

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BPL Travel Personal Profile Form

If you have filled out this form before and you are just adding additional information, you only need to complete your name and the fields you would like us to update.

Personal Information

What is your full legal name as as it appears on your government issued I.D.? This is for TSA purposes, please make sure it matches exactly.

First Name

Middle

Last Name

Company

Home Phone

Work Phone

Mobile Phone

Email Address

Home Address

City

State

Zip Code

Birthday Month

Birthday Date

Birthday Year

Required for TSA purposes

TSA Pre- Verify the name above matches EXACTLY as the name appears on your TSA Pre-

Global Entry - Verify the name above matches EXACTLY as the name appears on your Global Entry.

Known Traveler Number (KTN) - Verify the name above matches EXACTLY as the name appears on your KTN

Gender

MaleFemale

Airline

Seat Preference

AisleWindowNo preference for aisle or window ForwardAftBulkheadExit row

Airport Departure Preference - 1st choice

Airport departure preference - 2nd choice (leave blank if no second airport choice)

Do you wish to enter airline frequent flyer numbers at this time?

Yes

No

Airline Frequent Flyer numbers

Alaska Airlines Mileage Plan

American AAdvantage

Delta Skymiles

Frontier Early Returns

JetBlue Trueblue

Southwest Rapid Rewards

United Mileage Plus

Virgin America Elevate

Other (please enter both the name and frequent flyer number)

Other (please enter both the name and frequent flyer number)

Hotel

Preferred Bedding

KingTwo double or queenNon-smoking roomSmoking room

Hotel Preferences

GymRoom serviceOn site restaurantHotels only - no motels

Do you wish to enter hotel frequent guest numbers at this time?

YesNo

Hotel Guest Numbers

Best Western Gold Crown

Choice Priveliges

Fairmont President's Club

Hilton HHonors

Hyatt Gold Passport

Intercontinental Priority Club

Marriott Rewards

Radisson Club Carlson

Ritz Carlton Rewards

Starwood Preferred Guest

Other (please enter both the hotel name and guest number)

Other (please enter both the hotel name and guest number)

Car Rental Preferences

Preferred car category

Subcompact (Kia Rio, Chevy Spark or similar)Compact ( Nissan Versa, Ford Focus or similar) Midsize (Toyota Corolla, Mazda 3 or similar) Standard (Chrysler 200, Nissan Altima or similar)Full Size (Ford Fusion, Chevy Impala or similar) Premium (Chrysler 300, Nissan Maxima or similar) Luxury (Lincoln MKS, Cadillac STS or similar) Compact SUV ( Ford Escape, Toyota RAV4 or similar) Midsize SUV (Ford Explorer, Toyota 4Runner or similar) Full size SUV (Ford Expedition, Chevy Suburban or similar) Least expensive regardless of size

Other car options

GPSEZPassOn terminal locations only

Do you wish to enter car rental express memberships at this time?

Yes

No

Car Rental Express Memberships

Avis Wizard

Budget Fastbreak

Hertz Gold

National Emerald Aisle

Other (please enter both the car company and express number)

Other (please enter both the car company and express number)

Please let us know of any special requests you have, or ways that we can insure your travel experience is as pleasant as possible.

Credit card information will be collected if necessary during your first booking.

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