Company Information
Please fill in the information you want printed in the Official Directory of services.

Company/Organization Name:

 

Mailing Address:

 

City/State/Province:

 

Zip Code/Postal Code/Country:

 

Telephone:
Please include the country code and city code, and/or area code, where applicable.

 

Fax:

 

E Mail:

 

Website (T):

 

Primary Contact:
Please indicate who should receive the confirmation letters, invoices and all other related information.
If contact is attending, please enter also as delegate

 

Primary Contact E Mail:

 

Delegate Information:
List the names and titles of the Delegates who will be attending from your company.

Delegate 1: First Name/Last Name/Job Title
 

Delegate 2: First Name/Last Name/Job Title

Delegate 3: First Name/Last Name/Job Title

Delegate 4: First Name/Last Name/Job Title

Marketing Information

A. What are your business activities?
01. Association
02. Educational Travel Planner
03. Incentive Buyer
04. Internet Travel Provider
05. Meeting Planner
06. Representative
07. Retail/Travel Agent
08. Tour Operator
09. Travel Club
10. Wholesaler
11. Other

B. What ticketing/reservation services do you provide/organize?
01. Accommodations
02. Airline Ticketing
03. Bus Transport/Ticketing
04. Car Rentals
05. Charters
06. Cruises
07. Special Events
08. Guide Service
09. Other

C. What tour services do you provide/organize?
01. Adventure Sports
02. Cruises
03. Ecotourism
04. Educational/Special Interest
05. Golf
06. History & Archeology
07. Luxury/High-End Tours
08. Meeting & Incentive
09. Sightseeing
10. Spa & Wellness
11. Student Groups

E. What regions of Ecuador do you currently send travelers?
01. Amazon
02. Andes
03. Pacific Coast
04. Galapagos
05. All Regions
06. None

G. What system does your Agency use?
01. Amadeus
02. Galileo
03. Internet
04. Sabre
05. Worldspan
06. None

J. How many years have you been in operation?
01. 1 - 5 Years
02. 6 - 10 Years
03. (+) 10 Years
04. (+) 20 Years
05. (+) 50 Years

K. How many travelers did you send to Ecuador last year?
01. Under 200
02. 201 - 500
03. 501 - 1000
04. 1000 - 5000
05. Over 5000

O. What percentage of your total annual sales is group business?
01. Under 10%
02. 10% - 15%
03. 15% - 25%
04. 25% - 50%
05. 50% - 75%
06. Over 75%

P. What percentage of your total annual sales is for leisure travel?
01. Under 10%
02. 10% - 15%
03. 15% - 25%
04. 25% - 50%
05. 50% - 75%
06. Over 75%

Q. What is your Agency Office type?
01. Branch Office
02. Head Office
03. Single Office/No Branch
04. Home Based
05. Other

R. What is your Agency's total annual sales in U.S. Dollars?
01. Under $500,000
02. $500,000 - $1 Million
03. $1 Million - $3 Million
04. $3 Million - $5 Million
05. Over $5 Million

S. Please provide information about your agency & its activities in Ecuador that will be of interest to Suppliers.
(Limited response to about 45 words)
 

Registration Fees

Please choose your registration option :
(Meet Ecuador Seminar Participants - See special rates further below)

	Double Accommodations Early Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $195.00 per delegate                          ==ON/BEFORE April 6, 2010==
	Double Accommodations Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $245.00 per delegate                          ==AFTER April 6, 2010==
	Single Accommodations Early Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $350.00 per delegate                          ==ON/BEFORE April 6, 2010==
	Single Accommodations Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $400.00 per delegate                          ==AFTER April 6, 2010==

 

SPECIAL MEET ECUADOR SEMINAR RATE: Travel Agents who attended the Meet Ecuador
Seminars in 2009 & 2010 qualify for the below special rates:

	MEET ECUADOR SEMINAR DISCOUNT Double Accommodations Early Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $125.00 per delegate  (instead of $195)                          ==ON/BEFORE April 6, 2010==
	MEET ECUADOR SEMINAR DISCOUNT Double Accommodations Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $175.00 per delegate (instead of $245)                          ==AFTER April 6, 2010==
	MEET ECUADOR SEMINAR DISCOUNT Single Accommodations Early Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $250.00 per delegate (instead of $350)                          ==ON/BEFORE April 6, 2010==
	MEET ECUADOR SEMINAR DISCOUNT Single Accommodations Registration (Includes double accommodations on May 16, 17 in Guayaquil, May 18, 19 in Cuenca, May 20, 21 in Quito - 2010) HOTEL TAXES NOT INCLUDED @US $300.00 per delegate (instead of $400)                          ==AFTER April 6, 2010==

Roommate Preference

OPTION 1: If you know of another Travel Agent who is attending and would like to share a room with them, please provide us their first and last name, and Agency name (if from another company).
Option 2:  Please room with with another Travel Agent based on the following options:
	Smoking
	Non-Smoking
	Gender:   Female
	Male
	Age:  18-30
	31-45
	Over 45

Choose Payment Method:

	Credit Card
	Company Check (In US$ &0 Drawn from a US Bank)
	Money Order
	Wire Transfer (A US$20 fee will apply for wire transfers)

 

Choose Confirmation Letter Method:
Email        Fax
 

Appointment Scheduling:

Does your Agency handle Groups?
YES          NO

Are you interested in requesting pre-scheduled appointments with Ecuador Suppliers in advance?  These appointments will be approximately 8-10 minutes each.
  YES          NO

Terms of Agreement

Please read the Terms of Agreement and check-off below. Form will not be processed unless the box marked "Yes" is checked:

All registrants are subject to the following terms and conditions: 1. All participation by any registrant must be approved by both William H. Coleman, Inc. (WHC) and Sponsor. Acceptance of registration by WHC is contingent upon subsequent acceptance by Sponsor. 2. Participants who register for the Program shall be entitled to cancel their registration in writing prior to the sixtieth (60th day) preceding commencement upon the Program, subject to a 50% cancellation fee. Thereafter, all registrants shall be deemed non-cancelable, and all registration fees paid or owing shall be deemed non-refundable or non-cancelable. 3. All social events hosted by any registrants during the Program and any pre and post Program fam trips sponsored by any registrant must be approved by WHC and Sponsor. 4. WHC and Sponsor reserve the right to cancel any registrant's registration without cause in their discretion at any time prior to the fifteenth (15th day) preceding commencement of the Program, conditioned upon full refund of such registrant's registration fee. 5. In the event of cancellation of the Program or any part thereof, because of a civil strike, civil discord, military action, natural event, or "act of God" occurring without fault on the part of WHC and/or Sponsor, there shall be no refund of fees paid or forgiveness of fees owed. 6. WHC and Sponsor shall not under any circumstances be liable for more than the refund of a registrant's registration fees upon cancellation of any registrant's participation or upon cancellation, in whole or part, of any program for any reason. WHC and Sponsor shall have no liability for consequential loss or damage of any kind arising out of any cancellation and their total and maximum liability shall be limited to refund of registration fees. Limitation of Liability: In consideration for accepting and processing this application and permitting registrant to attend the subject meeting, registrant hereby agrees to release and hold WHC and Sponsor, its officers and employees, harmless for any personal injury, loss, or harm occurring during, and while traveling to or from the subject meeting caused by third parties.
NOTE: Use Scroll Bar to view all terms.

I agree with the terms above

Name:

 

Date:

 

Form Submission

See Ecuador Travel Exposition. After submission, you will be given the payment options.

Please note that registration is not confirmed until all fees have been paid and are subject to approval by William H. Coleman, Inc.  THIS EVENT IS FOR TRAVEL AGENTS ONLY.  We must receive a copy of every delegates IATAN Card.  If you do not have an IATAN Card, another form of Travel Agent ID can be submitted - subject to approval, such as CLIA, TRUE, OSSN, etc..  You can fax a copy of your identification to 904-391-0038 or E Mail sales@whcoleman.com   William H. Coleman, Inc. reserves the right to reject any application if qualification and space availability requirements are not met.