Application Type *Select an optionNew MembershipRenewalAdditional Industry Partner ($60)

First Name *

Last Name *

Email Address *

Work Phone

Cell Phone *

Birthday

Company Name *

Position / Title *

Years with Current Employer

Address

City *

State

Zip Code *

Years in the Travel Industry

Florida Seller of Travel *Florida Seller of TravelYesNo

I have read and agree to the TIA Terms & Conditions *

I understand that Industry Partners are NOT eligible for prizes or TIA FAM trips *

I authorize TIA to share my contact information with travel advisor members (optional)

New/Renewal: $100 + $4 cc fee = $104 total. Additional representative: $60 + $2.40 cc fee = $62.40 total.