PA Travel Form Please complete information below so we can book your trip to Philadelphia to attend the PA Conference for Women. Note that we will be using United travel certificates for these reservations. Legal Name(Required)List your name EXACTLY as it appears on your ID. First Middle Last Date of Birth(Required) MM slash DD slash YYYY From (Airport Code)(Required)To (Airport Code)(Required)Departure Date(Required) MM slash DD slash YYYY Return Date(Required) MM slash DD slash YYYY Preferred Departure TimePreferred Return TimePreferred Seating (ie. aisle, window)United MileagePlus Number (if any)Known Traveler Number or Redress Number, if anyPhone(Required)Email(Required) Notes: Please use this field to communicate specific requestsEmailThis field is for validation purposes and should be left unchanged.
