Travel Agent Program Registration Form

Welcome to GeoPassage.com!

Please fill out the following information in order to help us better serve your needs. Upon receipt of this form, we will send you an email confirming your registration and explaining our commission policy.

If you have any other questions, please call us toll-free at 1-800-246-3429 Monday to Friday 9 AM to 7 PM CST. Our fax number is 512-857-0077.

* indicates required field

Please fill out the following form in its entirety.

*Agency Name:


*Primary Contact Name:


*Email Address:


*Agency Address:

Street	:
City	:
State	:
Zip Code	:

*Phone Number:


*ARC#:

*Revenue (Annual) :
Total Booking	:
Percent from Ticket Sales	:
Percent from package/FIT sales	:

*Web Site Address:
Http://

*Where did you hear about us:
Article Banner Ad Customer Referral Email Newsletter From A Friend Mailer News group Newsletter Newspaper Ad Newspaper Ad: National Law Journal Newspaper Ad: New York Times Newspaper Ad: Washington Post Other (Please Specify) Radio Ad Search Engine: ... Search Engine: Altavista Search Engine: AOL Search Engine: Ask Jeeves Search Engine: Excite Search Engine: Go Search Engine: Google Search Engine: GoTo Search Engine: Hotbot Search Engine: MSN Search Engine: Other (Please Specify) Search Engine: Yahoo Television Television Show Tourism Board Travel Tips Unknown/Unspecified Website (Please Specify)    Details:

Top destinations/areas your Agency specializes in : (List Countries) (seperate countries by commas, i.e. - France, India, Brazil ect..)


Please tell us about your Agency: