Direct Relief, Health Equity Summit

Dear Awardees, Advisory Council and Board members, Moderators and Presenters:

Thank you for attending the summit, we look forward to seeing you at this special gathering. Please fill out the information below and a representative from Santa Barbara Travel will contact you shortly to finalize your travel arrangements. If necessary, you may contact the travel agents directly. The Health Summit agents are:

Primary Agent: Anna Kirkwood, Ph:805-869-1116 ext. 116 or email akirkwood@sbtravel.com

Secondary Agent: Emily Lakner, Ph: Direct: 805-869-1122 ext. 112 or email elakner@sbtravel.com

Please fill out the information below and a representative from Santa Barbara Travel will contact you shortly to finalize your travel arrangements. If necessary, you may contact your travel agent directly by using the contact info at the bottom of this page.
PERSONAL INFORMATION
Primary Traveler Name

PLEASE ENTER YOUR NAME EXACTLY AS IT APPEARS ON YOUR GOVERNMENT ISSUED PASSPORT OR PHOTO ID.

* Indicates required field
Name*
First Middle Last
CONTACT INFORMATION
Email*
Business Phone (w/ country code)
Mobile Phone (w/ country code)
Contact Preference
- Phone
- Email
Emergency Contact Name
First Last
Emergency Contact Phone
GENERAL INFORMATION
Date of birth (MM/DD/YYYY)*
MM slash DD slash YYYY
Gender*
- Male
- Female
- Other
FREQUENT FLYER INFORMATION
Example: United/32H67B
FF Carrier 1 /Number
*If you have more than one Frequent Flyer number please specify in the comments section below.
FF Carrier 2 /Number
*If you have more than one Frequent Flyer number please specify in the comments section below.
FF Carrier 3/Number
*If you have more than one Frequent Flyer number please specify in the comments section below.
FF Carrier 4/Number
*If you have more than one Frequent Flyer number please specify in the comments section below.
TRAVELER FLIGHT INFORMATION/ REQUEST
*Please specify any stopovers or additional flights in the special requests section
Outbound Flight
Departure Airport/ Arrival Airport
DFW-OGG
Departure Date & Preferred Time
08/20/20 Morning
Return Flight
Return Airport/Arrival Airport
DFW-OGG
Return Date & Preferred Time
08/20/20 Morning
OTHER INFORMATION
Special Requests
Please specify any special requests such as layovers or stopovers, in-flight seat arrangements, companion flyers, etc in the requests section below.
***A Santa Barbara Travel representative will contact you by phone or email to finalize your travel itinerary.

Direct Relief, Health Equity Summit

PERSONAL INFORMATION

Primary Traveler Name

CONTACT INFORMATION

GENERAL INFORMATION

FREQUENT FLYER INFORMATION

TRAVELER FLIGHT INFORMATION/ REQUEST

Outbound Flight

Return Flight

OTHER INFORMATION

If you need immediate assistance, please call us at 805-966-3116 and ask for a corporate travel agent.

Santa Barbara

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