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Booking Form - Dixie UTST
Please note, quotes are subject to rates and availability. Payment will not be processed if rate has changed, and you will be notified. This form allows for 6 passengers to be booked on one form. You only need to fill out one name, date of birth and airline seat preference per passenger. If your group exceeds 6 passengers, please submit two forms. A $25/person booking fee was included in your quote total.
Please let us know the date and destination of the quote you are interested in booking.
Name as it appears on your passport or ID for domestic travel.
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First
Last
Date of birth
Airline seat preference (aisle, center, window) *Please note, seat assignments are not guaranteed and are selected based on availability at the time of booking. The airline reserves the right to adjusts seats due to a schedule change, equipment change, etc.*
Airline Rewards Number
Name as it appears on your passport or ID for domestic travel.
First
Last
Date of birth
Airline seat preference (aisle, center, window)
Airline Rewards Number
Name as it appears on your passport or ID for domestic travel.
First
Last
Date of birth
Airline seat preference (aisle, center, window)
Airline Rewards Number
Name as it appears on your passport or ID for domestic travel.
First
Last
Date of birth
Airline seat preference (aisle, center, window)
Airline Rewards Number
Name as it appears on your passport or ID for domestic travel.
First
Last
Date of birth
Airline seat preference (aisle, center, window)
Airline Rewards Number
Name as it appears on your passport or ID for domestic travel.
First
Last
Date of birth
Airline seat preference (aisle, center, window)
Airline Rewards Number
Please list any Global Entry or Known Traveler Numbers below. Please note, our office makes every effort to add these to your reservation, but there are instances they can not be added. We highly advise to make sure they are attached to your boarding pass when you do your online check in (they may be added online in app or by the ticket counter at the airport):
Name
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First
Last
Billing Address
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Phone
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Email
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Authorized Amount
$
Dollars
.
Cents
Credit Card
*
Card Number
Expiration
MM
/
YY
CVV
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3 or 4 digit number printed on the back/front of your credit card
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Travel insurance is a way to protect your investment. We offer a wide variety of options. If you would like more information, please hit accept. Cancel for any reason insurance has to be booked at time of deposit. Other options may be available after deposit. If you choose to decline, please select decline. Again, if you decline insurance you are subject to all cancellation fees. In addition, some or all components may be nonrefundable and/or only refunded as a travel credit. If you have already added insurance, please hit accept. If you are accepting, please make sure the amount you are authorizing on your card includes the deposit plus the cost of the insurance.
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Please send information
Accept, I will list the option I selected below. Please be sure to include the cost of the insurance in authorized amount above.
Decline
If you were offered multiple options for insurance, please list the option you choose below. Travel Protections Plus-travel credit, Travel Protection Plus-cash refund, During Travel Protection. If this is not applicable to your trip, please skip this step.
Please list any additional information.
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