e Ticket

PERMANENT ADDRESS*

COUNTRY OF RESIDENCE *

CITY *

STATE / (ex: New York)*

POSTAL CODE*

DO YOU MAKE STOPS IN OTHER COUNTRIES?*

Yes

ARRIVAL TO THE DOMINICAN REPUBLIC

DEPARTURE FROM THE DOMINICAN REPUBLIC

NAMES*

LAST NAMES*

Date Of Birth*

GENDER*

MASCULINE

FEMININE

PLACE OF BIRTH*

IS THE NATIONALITY OF THE PASSPORT DIFFERENT FROM YOUR PLACE OF BIRTH?*

Yes

COUNTRY OF NATIONALITY*

PASSPORT NUMBER*

CONFIRM PASSPORT NUMBER*

CIVIL STATUS*

OCCUPATION*

EMAIL*

CONFIRM EMAIL*

What is your phone number? *

ARE YOU A FOREIGNER RESIDENT IN THE DOMINICAN REPUBLIC?*

Yes

RESIDENCE NUMBER*

ARE YOU LODGING IN A PRIVATE RENTAL? (e.g : Airbnb)

ARE YOU GOING TO STAY AT A HOTEL?

FAMILY/FRIENDS

OWN HOUSE

EMBARKATION (SHIP/FERRY)

Transit

COUNTRY OF DESTINATION*

HARBORS*

HOTEL*

ORIGIN PORT*

FLIGHT NUMBER*

FLIGHT DATE (YYYY/MM/DD)*

EMBARKATION PORT*

Dominicana E-Ticket