First Name*
Last Name*
TravelAid Order Number*
Your email*
Phone*
Secondary Phone
Date of birth*
Address Line 1*
Address Line 2
Town or City*
County*
Post Code*
Country*
My emergency contacts
Please list two people who you would like us to notify on your behalf in the event of an emergency and if you are unable to contact them yourself.
Primary emergency contact
First name*
Last name*
Emergency contact email
Relationship to you*
Secondary emergency contact
First name
Last name
Phone
Relationship to you
About my travel plans
Planned departure*
Planned return
Travel summary
Travel friends
Travel friends' email addresses
Tour operators
Project provider
Project completion date
File uploads
Passport* - Please upload a copy of your passport. This will be encrypted upon uploading for your added security
Passport Number*
Travel insurance* - Please upload a photograph of your travel insurance policy. IMPORTANT - we recommend that you take out an appropriate travel insurance. Please see further advice here https://www.gov.uk/guidance/foreign-travel-insurance Additional file upload spaces
Travel insurance 24/7 medical assistance telephone*
Travel Insurance Policy Number*
Privacy Policy I have read the privacy policy and agree to Pharos Response processing my personal information in my legitimate and vital interests. This may include notifying my emergency contacts if I am incapacitated or if I am unable to provide my consent to do so and when TravelAid believes that notifying my emergency contacts is in my vital or legitimate interests.
