Host_Agency_Renewal

Name/Title:
Agency Name:
Doing Business As:
Street Address:
City and State:
Zip Code and Country:
Telephone Contact:	Area Code Number
Fax:	Area Code Number
E-mail Address:
Website Address:

Check any of the following that apply: ARC IATAN CLIA SABRE
Amadeus Galileo Other
ARC Number IATA Number
CLIA Number

Please Complete the following as they apply to your business.

We carry Errors & Omissions Insurance Amount
I require all of the independents to carry their own policy.
Are you a Registered Seller of Travel in your state, if required?
Registration Number if applicable.
Approximate Agency Total Annual Sales Yearly
Average Annual Sales per Independent
Current Number of Independents

Renewal Calculation

Host Level II: $395

Payment Information
Please accept my NACTA Membership Renewal.
I will make payment by Check Credit Card

Credit Card Type
Credit Card Number
Expiration Date
Name as it appears on Credit Card

If paying by check, submit this form and follow with your check my mail to:
NACTA, Inc.
1101 King Street, Suite 200
Alexandria, VA 22314

*This NACTA membership is valid for one year from the date noted above. NACTA Host Agency Membership Renewal is $395.00 per year. Membership fees are non-refundable. The National Association of Commissioned Travel Agents neither guarantees nor insures that the service provided any officer, employee or member and shall assume no responsibility or liability for actions or events beyond its control in connection with services provided. Further members agree to hold NACTA harmless for any act, error, omission, injury, loss, accident, nonperformance, financial failure, or any other irregularity, or any consequences resulting there from, which may be caused from the neglect, default, or any other action of association, company, carrier, independent contractor or person engaged in the service of NACTA