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| Travel Agent Registration |
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| * Indicates a required field |
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| First name: |
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| Last name: |
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| Agency Name : |
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| What is your primary address (please indicate address where we send payments)? |
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| Street 1 : |
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| Street 2 : |
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| City: |
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| State: |
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| Country: |
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| Postal Code: |
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| Phone: |
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| FAX: |
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| E-mail: |
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| Web Site : |
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What best describes you and your agency's business?
(select one) : |
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| Please indicate the accreditation details you or your agency uses when making bookings with suppliers. |
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| ARC ID Number : |
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| CLIA ID Number : |
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| IATA ID Number : |
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| Other (Please specify name) : |
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| Other (please specify ID Number) : |
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| Please indicate the consortia that you are affiliated with: |
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| Other : |
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Please indicate the destinations that you sell
(select multiple): |
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| What was your percentage of bookings to Japan/Asia last year? : |
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| What type of travel do you sell most? : |
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| What is your agency's sales volume?: |
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| How many agents work in your agency ? : |
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