EmailMe Form - Galapagos Guest Information Form (LS))

Primary Contact/ Traveler Information

Please use this section for the primary contact for the vacation.

Name *

First Middle Last Suffix

Name exactly as it appears on government issued ID or passport for international travel

Date of Birth *

MM / DD / YYYY

Passport Expiration Date

MM / DD / YYYY

Exact date as it appears on your passport. If you are applying enter 00/00/0000

Second Traveler Information

Name

First Middle Last Suffix

Name exactly as it appears on government issued ID or passport for international travel

Date of Birth

MM / DD / YYYY

Passport Expiration Date

MM / DD / YYYY

exact date as it appears on your passport.

Lead Guest Address *

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

Primary Contact Email *

this email will not be shared or used for any other purpose but for this trip

Primary Contact Phone # *

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

Primary Traveler Initials *

I have reviewed all off the guest information above for accuracy and confirm that it is correct.

Special Room Requests (i.e. bedding, etc.)

Resorts will do the best to honor your requests based on availability but they are not guaranteed

Any dietary requirements?

Would you like to extend you trip, pre or post?

Would you like a quote on air and if so from what airport?

Galapagos Islands requires travel insurance. Would you like a quote?

International Travel

ALERT: Travelers are responsible for meeting all document requirements for travel. Guest Info Form must be submitted for each room being requested with info for each guest per room. It is important that dates of birth and names exactly as they appear on passports are provided. Passports are required for all travelers, regardless of age, and must be valid for at least 6 months beyond your travel dates. In the event of an emergency, no other documentation will be accepted for inbound foreign flights. For complete regulations regarding Passport requirements; visit www.Travel.State.Gov