Please fill out this form in its entirety. Incomplete forms will not be eligible for bonus AAdvantage award miles.

Individual who booked travel:

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Traveler Information:

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Ticket information:

Date Ticket was Purchased:*
Date of Departure*
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Disclaimer: I agree to release Executive Travel of liability in regards to whether the traveler or the individual booking the trip is awarded the bonus award miles. I acknowledge that is a decision that should be agreed upon by the traveler and travel arranger before completing this form. *