Agent Profile

Agent Name * (e.g. PT. ABC Travel)
District / State
select
*
Number of Stores * (Number of your agency locations/stores)
Number of Users * (Number of Sign in that needs access to our Portal)
Company Type * (Private or Public Company)
Company Number * (Your Official Company Registration Number)
IATA Number (Leave blank if non-IATA) (Max. 15 chars/spaces)
Tourism Registration Number *
Manager's First Name *
Last Name
Email Address (Your Person In charge for the Account)
* (Please note that we will send our promotion information to this email address)
Phone Number *
Fax Number
After Hours
Mobile
Address 1 *
Address 2
City *
State *
Country
select
*
Postcode *
Login Name *
Login Password * (Your Password should be with a minimum of 6 characters, and it should contain a Captial letter, a Special charater and a number 'Ex: A@2abc)
Confirm Password *
Please Enter the Captcha Code