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 order 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 deeply discounted bulk fares may be available on cash basis only.

Name:    


Address: 

City:    State: Zip: 



Telephone(Work): 

Telephone(Home): 


Fax:(Full time fax) 


Email:  Required

Email (re-enter): Required

Your itinerary will be emailed or faxed to you.
Please make sure your email address can receive attachments and/or your fax is on.
Comments: