Skip to content

Home
About
Autism & Special Needs
Disney
Destinations
Travel Essentials
- The Travel Store
- Customized Packing Guide
Inspiration
Contact Us
For Clients

***OLD KaliKosmos Travel

Passenger Information Form

Please enter each passenger’s FULL name (first, middle, last), date of birth, and gender as the information appears on the identification which will be used when traveling. Travelers 18 and over will all be required to sign the agency’s General and COVID Disclaimer before payment can be applied. Please provide individual contact information to assist in this process.

Name as it appears on this passenger’s ID that will be used for travel

For some people, names on their driver’s license are different from their names on their passport. Please consult your proper form of ID for the correct information.

First Name(s) *

Middle Name(s)

Last Name(s) *

Date of Birth *

Gender *

State of Residency *

A factor for insurance pricing.

Email *

Phone *

Country of Citizenship *

Are you part of any of the following groups

Active Military
Retired Military
AARP
U.S. or Canadian Law Enforcement
Fire Department or EMT

Have you received a COVID19 vaccination? *

Yes
No

Vaccination Details *

Single dose vaccination (ie Johnson/Johnson)
One dose of multi-dose vaccine
Two doses of multi-dose vaccine
Fully vaccinated + booster

Do you have any of the following passenger identification numbers?

TSA Pre
Known Traveler
Redress
Other
None

TSAPre *

Known Traveler *

Redress *

Other *

Do you have special needs/requests such as meals, pets, or mobility?

Yes
No

Special Needs/Requests *

Do you have preferences about your seating on a plane?

Yes
No

Seating Preferences *

Do you have frequent flyer accounts?

Yes
No

Frequent Flyer Accounts *

Alaskan Airlines
American Airlines
British Airways
Delta Airlines
Emirates
KLM
Korean Air
LATAM
Lufthansa
Qantas
Southwest Airlines
Sun Country
Turkish Airlines
United Airlines
Unlisted

Alaskan Airline Account Number *

American Airlines Account Number *

British Airways Account Number *

Delta Airlines Account Number *

Emirates Account Number *

KLM Account Number *

Korean Air Account Number *

LATAM Account Number *

Lufthansa Account Number *

Qantas Account Number *

Southwest Account Number *

Sun Country Account Number *

Turkish Airlines Account Number *

United Account Number *

Unlisted Account Name and Number *

I am traveling as part of a team, group, or extended family member experience *

Yes
No

Main Contact's Name/Travel destination *

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

The Transportation Security Administration (TSA) requires you to provide your full name, date of birth, and gender for the purpose of watch list screening, under the authority of 49 U.S.C. section 114, the Intelligence Reform and Terrorism Prevention Act of 2004 and 49 C.F.R parts 1540 and 1560. You may also provide your Redress Number, if available. Failure to provide your full name, date of birth, and gender may result in denial of transport or denial of authority to enter the boarding area. TSA may share information you provide with law enforcement or intelligence agencies or others under its published system of records notice. For more on TSA privacy policies, or to review the system of records notice and the privacy impact assessment, please see the TSA Web site at www.tsa.gov. In most cases, airlines request passenger’s phone number, emergency contact, email address, and, in some cases, address of residence or destination. When requested by the airline, this information will also be transmitted.

It is the traveler’s responsibility to provide the correct documents and failure to do so may result in being denied boarding for the flight. Regrettably, we are unable to refund unused flights, hotel, or add-ons because of denied boarding situations.

Edmond, Oklahoma

405.694.0506

© Kalikosmos Travel 2021. All rights reserved.