Email:
(lowercase )
Confirm Email Address:
(lowercase )
Name (first and last name please):
(upper/lowercase )
Company Name (if applicable):
(upper/lowercase )
Address:
(upper/lowercase )
City:
(upper/lowercase )
State:
(caps )
Zip:
Phone:
123-123-1234
Phone Type:
Home
Work
Cell
What is the Best Time to Reach You:
8:00 AM
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
6:00 PM
7:00 PM
8:00 PM
9:00 PM
10:00 PM
Your Website Address:
Where did you hear about us?
4TravelAgents.com
Agent@Home Magazine
Career Quest Training
Direct Mail
Email
Email-Travel Agent Promos
FAM News
Friend or Co-Worker
Galiano Career Academy
Google
Home-Based Travel Agent Magazine
Home Based Travel Agent.com
Home Based Travel Agent Community
Luxury Travel Advisor
Mailpound Webinar
NACTA
OSSN
Other
Peninsula Travel Shows
Postcard
The Travel Zone
Trade Show - ASTA’s The Trade Show
Trade Show – CLIA’s Cruise3Sixty
Trade Show - Cruise-A-Thon
Trade Show – Luxury Travel Expo
Trade Show – OSSN’s Home Based Agent Show
Trade Show - Tour and Cruise Travel World
Travel Age West
Travel Agent Campus
Travel Agent Magazine
Travel Weekly
TravelReferrals.com
Vacation Agent Magazine
What is your experience in the
travel industry?
Existing Agency Owner
Existing Agent
None
Other
Travel School Graduate
What Travel Industry Credentials do you possess? (check all that apply)
Approximate travel sales (last 12 months)?
$0 - $49,999
$50,000 - $99,999
$100,000 - $499,999
$500,000 - $999,999
$1,000,000 +
When are you looking to possibly
join TPI?
Within Next Week
Within Next Month
Within Next 3 Months
Within Next Year
When my contract expires with my current host
When my membership ends with CLIA
Comments (If you are currently working with another host agency or have your own CLIA/ARC/TRUE number, please use this area to explain your current situation and let us know how we can earn your business):
Verification Code (type letters and/or numbers exactly as they appear):