Agency Name (First & Last): (required)
Password for Agent-Only Access (required) Please use 5-10 characters.
Agent's Name: (at least one agent name/email required) Please list all agents that you feel would like to receive info on our Commission Bonuses, Fams & Specials. List the agent in the first box, then the email address in the second, and repeat for up to 10 agents. Email addresses are the ONLY way we stay in touch with you!! To give us both a home and business email address for an individual agent in these days of agency uncertainties, just enter both in their email box, separated by a comma.
Agency Phone #: (required) US phone numbers - please enter in the following format: 802/555-1212
Agency Fax #: US phone numbers - please enter in the following format: 802/555-1212
Agency Street/Snail Mail Address: (required)
Agency City: (required)
Agency State: US Agencies, select from the pull-down menu. Others, please type state, if appropriate, in the text box.	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Agency Zip Code/Postal Code:
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Agency Website: www.DoinItRightAgents.com does not list our phone # or a way for your client to contact us directly so you're safe to link this to YOUR website. For a free banner, click here, and have your webmaster use one of the banner ad graphics there, linked to http://www.doinitrightagents.com. Contact our webmaster, mongoose@ mongooseontheloose.com, with any questions
Member of: Check all that apply.	IGLTA NACTA OSSN TAG CLIA ARTA ASTA
Client Specialties: Check all that apply.	Families Singles Gay Straight Honeymooners/Weddings Corporate Upscale Cruise (DIR can help your cruise clients while in port!!) Seniors College/High School Grad Trips/Spring Breaks (DIR does not work with this clientele)
Source: How did you find us?	DIR Email DIR Presentation Surfing Net Email Blitz from another source: IGLTA ETurboNews.com Travel-Telegram.com FamNews.com FamFax Travel Publication: Other:
Interested in Our Fams?:	Yes No 4/25-4/30/02 Future
Comments:

Once we receive your info, we'll add you to our database, and give you access to our Agents Only section when it goes live later this month.