Membership Application Form

Client Information and Travel Policy

Name must match spelling on id documentation: license or passport. Alpha Journeys will not be held responsible for receiving incorrect information. Prices are not guaranteed until deposit or full payment is completed.-- No airline ticket may be transferred to another person at any time.- Cruises: A deposit of $250/person is due at the time of booking in order to secure a cabin on the ship.- It is the responsibility of each traveler to know what documentation is required for entry into another country by going to http://travel.state.gov- It is recommended that travel insurance is purchased for all trips. Alpha Journeys will not be held responsible for failure to comply.
Name *

Prefix First Name Middle Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Home Number

Area Code Phone Number
Cellular Number *

Area Code Phone Number
Date of Birth *

Month Day Year
Citizenship *
Emergency Contact (not traveling with you) *

First Name Middle Name Last Name
Emergency Contact Phone *

Area Code Phone Number
Emergency Contact Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Passport Information
Birth Country
Passport Number
Issue Date

Month Day Year
Expiration Date

Month Day Year
Issuance Country
Special Celebrations
Handicap Needs
I have read the Client Information and Travel Policy *

Yes
Should be Empty:

Client Information and Travel Policy