Airline Tickets Order Form

To send this form via e-mail please fill it out and click on the "SEND" box at the bottom of the form.
You do not need to provide credit card number on the quote-form.

Note: See How to Order before you complete this order form. The order form must include flight numbers, airlines, confirmation number, published airfares, phone #, e-mail address and/or fax numbers. Only published fares above $600 per ticket will be quoted.

TRAVEL DISCOUNTERS
Phone: 408-238-5297
Fax: 408-238-5397
E-mail: ticket@traveldiscounters.com
Contact Us: tdair@pacbell.net

Open: 10am - 5pm Pacific (Mon-Fri)

Passengers List

Last Name First Name 1. 2. 3. 4.

Departure

Date: --
month - day - year
From:
To:
AirlineRequired
(AA UA CO TW US DL NW HP ....ALL AIRLINES)
Flight# Time:
Flight# Time:
Flight# Time:
Flight# Time:

Return

Date: --
month - day - year
From:
To:
AirlineRequired
Flight# Time:
Flight# Time:
Flight# Time:
Flight# Time:
Confirmation No:
You can get a confirmation number and a 24-hour hold on your reservation from the airlines
without giving your credit card number.

Published Fare $: (Including all taxes PER ticket)
REQUIRED - we need to know the price to beat.

Frequent Flyer Miles :
For proper credit to your FFM account.

Payment Method: Visa MasterCard Discover American Express I will fax you back the discount itinerary page with my account number.

Account Number:
Expiration Date:

Note: Some bulk fares may be available on cash basis only.

Name:    

Address: 

City:    State: Zip: 



Telephone(Work): 

Telephone(Home): 

Fax:(Full time fax) 


We can either email or fax your itinerary.   
Please make sure your fax is on and/or are able to receive email attachments.

Email:  Required

Email (re-enter): Required

Comments:

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