A Hogg Robinson Group company.

1
Traveller Profile and Data Protection Consent Form
The following details are required to enable HRG UK to provide immediate confirmations and
advices in respect of your travel arrangements.
Please note: irrespective of who completes the Traveller Profile section of this form, the traveller
him/herself must be the person who reads and completes the Data Protection Consent section.

1. MANDATORY REGISTRATION DETAILS
The following sections contain all details that are required for the initial registration of a Traveller
Profile with HRG. Please note all fields denoted with an asterix * mandatory items and a profile
cannot be created without this data.

Personal Details
Please ensure this is the name as shown in Passport
Title * First Name
Middle Name * Surname:
Date of Birth


Contact Details
* Email Address
* Business Phone *Home Phone
*Mobile Phone Business Fax
Additional Email 1
Additional Email 2

Next of Kin Details
Name Contact Telephone Number Next of Kin


Passport 1 Details / APIS Information
Nationality*
Passport Number*

Expiry date*
Issue Date* Place of Issue*
Country of
Issue*

Country of Residence




A Hogg Robinson Group company.
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Home Address*
Full address*


Post Code*


Business Address
* Business
Address


Post Code


Company Details*
Department PPM Development Excellence
COST
CENTRE*
Admin: Karen Notley karen.notley@roche.com
1175155201 Line Manager: Jeff Titman jeff.titman@roche.com

Individual Corporate Credit Card *
Credit Card Supplier* Citi Mastercard Number
Name on card Exp




2. OPTIONAL DATA / TRAVEL PREFERENCES

The following sections contain all additional details that are optional and can be stored within a
Traveller Profile

VISAS BEING HELD ON PASSPORT 1*
Visa Country Visa Number Expiry date Type





Passport Two
Nationality Passport Two If British please advise
status

Number Expiry date
Visa Country Visa Number Expiry date Type



A Hogg Robinson Group company.
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Personal Car Details
Make Model Reg No Colour
Credit Card Number Exp
Driving Licence Number
International Driving Licence Number

Air Seat Preferences
No Preferences

Window Aisle Centre
Left Right

Air Special Preferences
Meal Preferences
Special requests i.e. wheelchair/Meet and Assist
Supplementary Information

Airline Membership Cards
BA Executive Number
Airline Card No Airline Card No











Hotel Membership Cards
Hotel Card No Hotel Card No

Car Hire Membership Cards
Car Hire Company Card No Car Hire Company Card No



DATA PROTECTION CONSENT
I acknowledge that one or more members of the HRG worldwide network and any successors
has been engaged by my employer to provide the travel management services (including


A Hogg Robinson Group company.
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management information reporting) which my employer requires ("Services"), and that in
connection with the Services my employer will, either alone or, to the extent provided for by
local law, jointly with HRG, be controlling the uses made of data relating to me for the
purposes of applicable law(s).
I also acknowledge that: (a) in the course of providing the Services, HRG will receive, process
and transfer the data which I provide to HRG about me and my travel preferences (which may
include payment information and data relating to my health (e.g. if I request wheelchair
access), religion/racial/ethnic origin (e.g. if I have special dietary requirements) etc) and also
other information relating to my travel activities received by HRG e.g. as provided to HRG by
or on behalf of my employer (collectively, "my data"); and (b) my data will inevitably be
transferred across international borders (including potentially inside and outside the European
Economic Area ("EEA")) during HRG's provision of the Services.
I hereby explicitly consent to: (a) my employer and HRG collecting, processing and
transferring my data across international borders (including both inside and outside the EEA)
in relation to the Services including (amongst other things) HRG: (i) creating, storing and
administering my traveller profile; and (ii) transferring my data to airlines, hotels, travel -related
reservation systems, car hire and other travel suppliers; and (iii) collecting and processing my
data and transferring it to my employer or my employers nominee(s) as part of their
management information and travel monitoring requirements from time to time; and (iv)
transferring my data amongst HRG members and their suppliers, data storage and other
service-providers as necessary for the provision of the Services; and (v) for the purpose of
fulfilling my employer's customer satisfaction survey requirements; and (vi) for fraud
prevention purposes and as HRG believes in good faith is required by law or other
regulatory/auditing requirements; and (vii) transferring my data, as necessary to fulfill any
existing bookings, to my employer and/or any travel company(ies) appointed by my employer
as a replacement for, or in addition to, HRG; and (b) my employer transferring (or arranging
for the transfer) to HRG of the travel-related data about me currently held by them and/or their
travel agent(s).
I understand that my data will not be passed to third parties for their direct marketing
purposes.
I confirm that I will always provide accurate information to HRG and I agree to update it as
necessary. I agree that, in the absence of any update, HRG may assume that the information
I have provided is correct.
I understand that I can find out what information HRG holds about me by writing to the Data
Protection Officer (Global House, Victoria Street, Basingstoke, Hampshire, RG21 3BT, UK)
and that a modest charge may be made for this.
I confirm that I, the traveller, have read, understood and accept the terms of this Data
Protection Consent: Please put an X in the box to confirm (if submitting this Consent
electronically) OR sign below to confirm if submitting in hard copy:
Signed: