Request Form for Cobranded Website

Welcome to your Regent Seven Seas Cruises co-branded website program. With just a few simple steps you can create a special website for your clients to use when shopping for Regent Seven Seas Cruises. They will see up-to-date information from Regent Seven Seas Cruises and contact you directly to get more information or make a reservation.

Your Regent Seven Seas Cruises co-branded website contains forms that allow visitors to communicate with your agency. All information is emailed directly to you and is not seen or collected by Regent Seven Seas Cruises.

Personal Contact Information - Will not be shown on your website.

Please first tell us about you, the person we should contact if we have any questions.

* Fields with a red asterisk are required.

First Name: Last Name: Job Title: Street Address 1: Street Address 2: City: State/Province: Postal Code: Country: Contact Email: Contact Phone Number: Fax Number: ARC/CLIA Number: Independent Contractor? (Through a Host Agency):

No Yes

Travel Agency Information - Will be listed on your website.

Now, tell us about the agency that will be using the Regent Seven Seas Cruises co-branded website.

* Agency Name: * Agency Logo:

Instructions: Logos will be resized to 230px wide by 100px high. Only JPG/JPEG files.

Agency Website URL:

Instructions: Complete URL (e.g. http://www.abctravel.com)

Twitter URL:

Instructions: Complete Twitter URL (e.g. http://twitter.com/abctravel)

Facebook URL:

Instructions: Complete Facebook Page URL (e.g. http://www.facebook.com/abctravel)

Blog URL:

Instructions: Complete Blog URL (e.g. http://blog.abctravel.com)

* Main Email:

Instructions: Email address that consumer requests will be sent to.

* Main Phone Number:

Instructions: This is a SINGLE phone number, formatted xxx-xxx-xxxx, for display at the top of all pages.

Other Office Phone Numbers:

Instructions:If you have more than one location, use the "+" button to add rows. Note that only the FIRST location will show on Privacy and Legal pages. Use this to put in a block of phone numbers for your office, for example:

        Toll Free: xxx-xxx-xxxx
        Phone: xxx-xxx-xxxx
        Fax: xxx-xxx-xxxx

	Location Name	Phone Numbers
	Leave this blank if you have only one office!
1	128

* Office Hours:

Instructions: Enter your agency's office hours. If you have more than one office and they have different hours, list ALL offices and their hours.

* Office Address(es):

Instructions: Enter your agency's address. If you have only one address, leave "Location Name" blank. If you have more than one office or address, click the "+" button to add rows to the table, and enter one address per row.. Note that only the FIRST address will show up on Privacy and Legal pages!

	Location Name	Address Block
	Leave this blank if you only have one address!
1	128

State Seller of Travel Numbers:

Instructions: Enter all your required state seller of travel numbers by selecting the state and entering your number. Click the "+" button to add more rows for more states.

	State	Seller of Travel Number
1		140

*About Page text:

Instructions: Paste in the text that will be seen on your agency's "About Us" page.

Affiliate Logos:

Instructions: Select any affiliate logos you would like to have appear on your site.

Consortium:

Instructions: If you are part of a consortium, please select it. If it is not listed, type the name in the "Other Consortium Not Listed" box

Other Consortium Not Listed:

Accept terms of use

By clicking "Submit", below, you agree to the following:

Terms of Use:

The purpose of this co-branded site is to help you sell Regent Seven Seas Cruises itineraries to your clients; it does not comprise a change in Regent Seven Seas Cruises's relationship with its travel agent partners. Regent Seven Seas Cruises makes every effort to keep all site content up to date, but reserves the right to correct or revise pricing or dates throughout the season.