TRAVEL AGENT SUPPLEMENTAL APPLICATION
1
TOURS
a. Do you
arrange them; or
b. Are there student tours?
buy them from another agent? (Check One)
Yes
No
If yes:
c.
i.
Who provides supervision?
______________________________________________________
ii.
Are hold harmless agreements signed?
Are the tours
foreign; or
Yes
No
domestic?
If foreign, please list the countries where tours take place:
__________________________________________________________________________________
__________________________________________________________________________________
2
ASSOCIATIONS
a. Please list any professional or organizations of which you are a member:
__________________________________________________________________________________
__________________________________________________________________________________
b. Circle conferences in which you hold appointments:
ATC IATA IPSA IPPC
3
ASTA AMTRAK
Other(Specify):______________________
FEES & RECEIPTS
a. Estimated Fees and Receipts for new policy year: $__________________________
b. Estimated commissions for new policy year:
$__________________________
I understand information submitted herein becomes a part of my Application and is subject to the same
representation and conditions.
_____________________________________
_____________________________________
Name of Applicant
Title (Officer, partner, etc.)
_____________________________________
_____________________________________
Signature of a person authorized to execute
Date
on behalf of the Applicant.
Page 1 of 2
TravelApp
Page 2 of 2
TravelApp