InteleTravel - enrollment form
Part 1: Primary Agent Information:
First Name:
Middle Initial:
Last Name:
Social Security No.:
Company:
Address 1:
Address 2:
City:
State: Zip/
Postal Code:
Province/Region:
(if outside US)
Country:
Business Phone:
Home Phone:
Fax Number:
Your Birthdate:
  Month:   Day:   Year:
        
Your Gender: Male    Female
E-mail:
Retype
E-mail:
Please note: If you have a spam blocker or filters set up for your email account, please unblock customerservice@inteletravel.com to ensure the receipt of your confirmation email.

How did you hear about us?
An InteleTraveler Agent Referred Me:
ENTER AGENT PIN #.
A PIN # IS THE ONLY WAY TO CREDIT AN AGENT.
If this box already has a code in place DO NOT edit or delete that code.

Note - If you were NOT referred by another Agent, please select an item that most closely indicates how you found us:
Part 2: Independent Contractor Agreement:
InteleTravel Agent Training Manual     View print version of Contract
Please note, our Training Manual has a .pdf format and must be read using Adobe Reader. If you do not have Adobe Reader, click here to install.
Initials: 03/17/2010 My initials indicate that I have read and accepted all terms on all pages of the above agreement.
You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.
Part 3: Click to Select Payment Method:
New InteleTravel Independent Travel Agent
$199 accreditation fee plus $9.95 monthly access fee
    OR
SAVE! $289.00 Annual Plan
(12 months, no additional monthly fees)

Shipping, Handling and Production of Agent Photo ID Card: $7.95
Payment Method:
Credit Card:
Card Number:
Expiration Date: /
Cardholder Name:
(as it appears on card)
Billing Address:(Same as Shipping)
Address 1:
Address 2:
City:
State: Zip/
Postal Code:
Province/Region:
(if outside US)
Country:
  BY SUBMITTING, I INDICATE THAT I HAVE READ AND ACCEPTED ALL TERMS ON ALL PAGES OF THE INDEPENDENT CONTRACTOR AGREEMENT