American Express Corporate Vacations Online

CAll US AT: 800-223-2680 OR FAX: 313-323-6430 OR USE THIS FORM TO E-MAIL YOUR REQUEST

CONTACT INFORMATION
First Name	Last Name
NOTE: Names must be completed as they appear on id

Address

City	State Zip

Email Address

Office Phone

Home Phone


TRAVEL INFORMATION
Destination/Package Choice

Preferred Departure Date

Preferred Departure Time

Preferred Return Date

Preferred Return Time

Alternate Departure Date 1

Alternate Return Date 1

Alternate Departure Date 2

Alternate Return Date 2


ADDITIONAL INFORMATION
Please note names of additional traveler(s). Note: Names must be complete as they appear on id

Please note any special requirements (i.e., Handicap accessible rooms, etc.)

Please note any special requests (i.e., king bed non-smoking, etc.) Note: This is a request only and can not be guaranteed.


DISCLAIMER
Corporate Vacations will make every attempt to confirm winners' preferences. For best availability, reservations should be made as far in advance as possible and no less than 30 days prior to departure. Packages, dates and travel times are subject to availability. All international destinations require proof of citizenship. Please refer to the individual package description for additional terms, blackout dates and/or restrictions specific to the prize award. Winners of the first half 2001 Business Growth Challenge program must book all travel by 1/31/02 and travel by 7/31/02. All American Express Travel offerings associated with the first half 2001 Business Growth Challenge programs expire 7/31/02. Certain blackout dates and other restrictions may apply. Clients may extend, upgrade or add additional persons for their vacation; however, they will be responsible for the added expense. Cancellation and change penalties may apply and vary by award option. Any such penalties will be the responsibility of the recipient. Travel insurance may be purchased. Please ask a travel counselor for details. Difficulties resulting from airline cancellations or missed connections should first be directed to the airline with which you are traveling. Travel emergencies should be directed to 1-800-851-8233.