EmailMe Form - DDInc Payment

Select Type of Payment

Please provide each traveler’s name EXACTLY as it appears in their passport and date of birth.

How many passengers? *

1. Name

First Last

1. Date of Birth

MM / DD / YYYY

1. Do you have a valid passport?

Yes

No

1. Gender on passport or government ID?

Female

Male

Undisclosed

1. Passport Expiration Date

MM / DD / YYYY

2. Name

First Last

2. Date of Birth

MM / DD / YYYY

2. Do you have a valid passport?

Yes

No

2. Gender on passport or government ID?

Female

Male

Undisclosed

2. Passport Expiration Date

MM / DD / YYYY

3. Name

First Last

3. Date of Birth

MM / DD / YYYY

3. Do you have a valid passport?

Yes

No

3. Gender on passport or government ID?

Female

Male

Undisclosed

3. Passport Expiration Date

MM / DD / YYYY

4. Name

First Last

4. Date of Birth

MM / DD / YYYY

4. Do you have a valid passport?

Yes

No

4. Gender on passport or government ID?

Female

Male

Undisclosed

4. Passport Expiration Date

MM / DD / YYYY

5. Name

First Last

5. Date of Birth

MM / DD / YYYY

5. Do you have a valid passport?

Yes

No

5. Gender on passport or government ID?

Female

Male

Undisclosed

5. Passport Expiration Date

MM / DD / YYYY

6. Name

First Last

6. Date of Birth

MM / DD / YYYY

6. Do you have a valid passport?

Yes

No

6. Gender on passport or government ID?

Female

Male

Undisclosed

6. Passport Expiration Date

MM / DD / YYYY

7. Name

First Last

7. Date of Birth

MM / DD / YYYY

7. Do you have a valid passport?

Yes

No

7. Gender on passport or government ID?

Female

Male

Undisclosed

7. Passport Expiration Date

MM / DD / YYYY

8. Name

First Last

8. Date of Birth

MM / DD / YYYY

8. Do you have a valid passport?

Yes

No

8. Gender on passport or government ID?

Female

Male

Undisclosed

8. Passport Expiration Date

MM / DD / YYYY

9. Name

First Last

9. Date of Birth

MM / DD / YYYY

9. Do you have a valid passport?

Yes

No

9. Gender on passport or government ID?

Female

Male

Undisclosed

9. Passport Expiration Date

MM / DD / YYYY

10. Name

First Last

10. Date of Birth

MM / DD / YYYY

10. Do you have a valid passport?

Yes

No

10. Gender on passport or government ID?

Female

Male

Undisclosed

10. Passport Expiration Date

MM / DD / YYYY

Confirm Dates of Travel

Departing *

MM / DD / YYYY

Returning *

MM / DD / YYYY

Package Information

Are you a Destination Wedding Guest or Group Member? *

Please give the name of the wedding couple, or group name, if "yes". Please remember to select your Travel advisor from the drop box below.

Name of Destination Wedding Couple or Group You Are Traveling With?

Name of destination wedding couple or group name?

Please use this Drop Down Menu to select the Travel Advisor working with you : *

In order to avoid payment delays you must select the travel advisor working with you, or the group or wedding you are attending.

Confirmation Number

If unsure, please leave blank.

Payment Amount *

$ Dollars

Billing Information

Name *

First Last

Billing Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email Address *

Phone Number *

### - ### - ####

Credit Card Information

Credit Card Company *

Credit Card *

Insurance

Travel insurance is not automatically included in your package and can be priced for you by your Dreams and Destinations Travel Consultant. Cancel for any reason insurance, if available, must be purchased with deposit. Catastrophic insurance options can be added after deposit, but are not cancel for any reason. Insurance is highly recommended as travel suppliers, airlines and resorts often charge fees for trip change/cancellation after payment has been made. Dreams and Destinations Travel Agency is not responsible for penalties or fees should you change or cancel your trip. The cost of insurance is nonrefundable and insurance policies are non-transferable.

Are you purchasing travel insurance? *

Yes

No

If no, please initial

Additional Comments?

Special instructions, type of accommodations etc.

Signature (Use finger or mouse to sign) *

Clear

By submitting, you certify that you are the cardholder and are authorizing Dreams and Destinations, Inc. or its chosen Tour Operator/Supplier/Cruise Line to charge the listed amount to the credit card. You certify that you have verified that all information contained in the confirmation you received is accurate. You also certify you have read the Terms & Conditions and the appropriate Travel Protection Plan details. Cancellation penalties may apply. Insurance is not refundable. This charge will be manually applied by your Dreams and Destinations travel professional to your reservation. If there are any issues, your agent will notify you. Please note, depending on the supplier used, that you may not see a charge from Dreams and Destinations on your credit card statement; the charge may come from our supplier and/or the airline directly. Payment may take 3-5 business days to fully process and be reflected on your statement. I authorize Dreams and Destinations, Inc to use the above information to charge my credit card the stated amount.

Terms and Conditions *

I Agree to the Terms