Contact VELTRA
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This is for US travel agents, if you are located outside of the US, please click
here
to sign up.
Account Information
*
=required
Agent name:
*
First name
Last name
Job title:
Job title
Email:
*
E-mail
Re-enter email:
*
Re-enter email
*Copy and paste disabled
Phone:
*
Phone
Mobile phone:
*
Mobile phone
Travel Agency Information
*
=required
Agency name:
*
Agency name
Website URL:
http://www.example.com
Country:
*
JAPAN
USA
Address line 1:
*
Address line 1
Address line 2:
Address line 2
City:
*
City
State/Province/Region:
*
State/Province/Region
ZIP:
*
Zip
Agency license number:
*
Agency license #
IATA / TIDS:
IATA / TIDS
Federal tax ID:
*
Federal tax ID
Bank Information for Commission Payment
*
=required
Swift-BIC code:
Swift-BIC code
Bank code:
*
Bank code
Bank name:
*
Bank name
ABA/Routing number:
*
ABA/Routing #
Branch code:
*
Branch code
Branch name:
*
Branch name
Account number:
*
Account number
Recipient name:
*
Recipient name
Account type:
*
Checking
Saving
Other
Bank address:
Address line 1:
Address line 1
Address line 2:
Address line 2
City:
City
State/Province/Region:
State/Province/Region
ZIP/Postal code:
ZIP/Postal code
Terms & Conditions
Please read our
VELTRA Travel Agent Program Terms & Conditions
carefully.
I agree to the VELTRA Travel Agent Program Terms and Conditions.
