Implementation Sales Rep* Select Your NameAmyValAgentDeniseLisa Email Client is TESTING with Blue Ribbon:* Yes No Company Name* Account CA* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone ex. format 2223334444 Fax ex. format 2223334444 Tax ID # Contact for Travel First Last Email Phone ex. format 2223334444 Add to Email List* Select OneCorporateLeisureCorporate & LeisureNone Contact for Reports First Last Email Phone ex. format 2223334444 Management Reports* Yes No Sort Fields Used* Yes No Creative Ticketing Liability Agreement Signed* Yes No Additional Contact First Last Email Additional Contact First Last Email Lead Agent Assisted Agents assigned to Account Select NameDeniseDiJackieJamieJennaJoleenKariKatieKristinLindseyLisaMichelle 2nd Agent Assisted Agents assigned to Account Select NameDeniseDiJackieJamieJennaJoleenKariKatieKristinLindseyLisaMichelle 3rd Agent Assisted Agents assigned to Account Select NameDeniseDiJackieJamieJennaJoleenKariKatieKristinLindseyLisaMichelle Online Tool Information Which Online Booking Tool? Select OneDeemConcur Concur Only Questions Number of Employees How is Payroll processed? (i.e. Paychex, ADP, etc.) Current Expense Reporting Process (i.e. SAP Travel Management in-house, web based expense solution, finance reporting software, manual spreadsheets, etc.) Monthly Expense Volume Select One:<100100-499500-1000>1000 Current Booking solution? (Agent Assisted, Internet, Deem, NuTravel, etc.) Lead Online Agents assigned to Account Select NameDiJackieJamieJennaKariKatieKristinLindseyMichelle 2nd Online Agents assigned to Account Select NameDiJackieJamieJennaKariKatieKristinLindseyMichelle 3rd Online Agents assigned to Account (There will always be 3) Select NameDiJackieJamieJennaKariKatieKristinLindseyMichelle Agent Assisted Service Fee* Online Agent Assisted Service Fee Southwest Direct Online Booking Fee No Touch Online Service Fee Land Only Fee Monthly Service Fee* Yes No All-Inclusive* Yes No Form of Payment Select OneIndividual CardsVisaMaster CardAmerican ExpressDiscover Credit Card Number Expiration Date i.e. 11/14 Air Only Card? Yes No Type of Credit Card Select OneCorporatePersonal Card Holder First Last Power of Attorney Form Signed Yes No Terms & Conditions Form Signed Yes No AIRLINE PROGRAMS 1st Airline Program Select OneDelta Sky BonusUnited Perks PlusAmerican Business ExtrAAAirTran A2BSouthwest Rapids RewardsSun Country UFly Rewards 1st Airline Program Account # 2nd Airline Program Select OneDelta Sky BonusUnited Perks PlusAmerican Business ExtrAAAirTran A2BSouthwest Rapids RewardsSun Country UFly Rewards 2nd Airline Program Account # 3rd Airline Program Select OneDelta Sky BonusUnited Perks PlusAmerican Business ExtrAAAirTran A2BSouthwest Rapids RewardsSun Country UFly Rewards 3rd Airline Program Account # CAR PROGRAMS Primary Car Program Select OneAlamo InsidersAvis PreferredBudget FastbreakDollar 4 BusinessEnterprise PlusHertz Gold Plus RewardsNational Emerald ClubPayless Perks ClubThrifty Smart Biz Primary CD# Primary Rate Special Instructions 2nd Car Program Select OneAlamo InsidersAvis PreferredBudget FastbreakDollar 4 BusinessEnterprise PlusHertz Gold Plus RewardsNational Emerald ClubPayless Perks ClubThrifty Smart Biz 2nd CD# 2nd Rate 2nd Direct Bill # Special Instructions 3rd Car Program Select OneAlamo InsidersAvis PreferredBudget FastbreakDollar 4 BusinessEnterprise PlusHertz Gold Plus RewardsNational Emerald ClubPayless Perks ClubThrifty Smart Biz 3rd CD# 3rd Rate 3rd Direct Bill # Special Instructions HOTEL INFORMATION Hotel Program Select OneClub CarlsonChoice PrivilegesHilton HonorsHyatt Gold PassportInterContinental Priority ClubMarriott RewardsStarwood Preferred GuestOther Hotel CD # 1st Negotiated Hotel 1st Rate 2nd Negotiated Hotel 2nd Rate 3rd Negotiated Hotel 3rd Rate Notes:
