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Travel Supplier -- General Information

Phone (We may need to contact you urgently for a number of reasons. These are the numbers we will use)
Intl. Code* Area Code* Number* Extension

Fax
Intl. Code Area Code Number Extension

* Required field

Supplier User Information

User	Login
Username	*
		Must be 6 to 20 characters using a-z and 0-9, including at least one letter.
Name
Title	*
First Name	*
Last Name	*
Email
Email	*
		This is the address we will use when we need to notify you of issues related to your account.

Supplier Commission Details (Please enter a value into one, and only one, of the three fields below)

Currency	*
Supplier Referral Commission
		CPC -- This is the fixed commission that you will pay when a targeted user is referred to your site. Please enter an amount and a currency, e.g. 0.50 GBP

Supplier Acquisition Fixed Commission
		Cost Per Acquisition (CPA) -- This is the fixed commission that you will pay when a user makes a purchase on your website as a result of a referral, within the 'Cookie Timeout' period. Please enter an amount and a currency, e.g. 10.50 GBP

Supplier Acquisition Percentage Commission		%
		Cost Per Acquisition (CPA) % - This is the commission that you will pay when a user makes a purchase on your website as a result of a referral, as a percentage of the purchase amount, within the 'Cookie Timeout' period. Please enter a number, e.g. 10

Supplier URL

Supplier Coockies

Supplier Cookie Timeout in Days	*	Days
		The number of days after a referral that a purchase can be considered to be related to the referral. Typically 30 days.

* Required field

I confirm that I accept the terms and conditions¹ set out in the enclosed Affiliate Marketing Partner Services