National Multiple Sclerosis Society

Translational Research Partnerships Investigator Meeting:
A Promise 2010 Initiative
January 14-17, 2009
Grand Hyatt New York

TRAVEL RESERVATION REQUEST FORM

Please complete the form below and submit it to Protravel International so we can help make your travel as smooth and pleasant as possible. Please make sure to enter your name as it appears on your government issued photo ID or Passport. Thank you!

Personal Information

 
First Name Middle Initial
Last Name Title
Email address to send
Electronic Ticket Confirmation
Assistant Name
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Business Phone Business Fax
Home Phone

Flight Request Information

Airline
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Departure
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Return
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Frequent Flyer Number
Seat Preference Window  Aisle
Special Requests

If you are making a reservation for a guest for whom you are paying, please submit a separate form and then call Dan at Protravel International direct with a major credit card number for billing purposes. 

         DANIEL KELLY 212-409-9510
         Outside Tri State Area 800-227-1059 Ext-510
         Fax 646-792-4529, EMAIL nmss@protravelinc.com

Thanks for using Protravel. Please make sure all the information provided is correct, and then click the FINISH button to submit your travel request, or print this form and Fax it to 646-792-4529. For questions or changes please email us at nmss@protravelinc.com, or call Protravel Direct. Please print a copy of this for your records.

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