Country/Territory

Point of Sale (Country/Territory)

Company Information

Agency Name

Trading Name

IATA or TIDS Number

Travel Agent Licence Number

ABN Number

GDS

GDS Pseudo City Code

Agency Chain Name *

Country/Territory

State/Providence

Address Line 1

Address Line 2

City

Postcode/Zip Code

Email Address

Confirm Agency Email Address

Phone

Qantas Client Identifier (QCI)

Main Type of Group Business

Secondary Type of Business

Main Contact Details

Title

First Name

Last Name

Job Title

Manager's Name

Work Phone

Mobile/Cell Phone

User Name

Password

Password is Invalid!

Email Address

Confirm Email Address

Secondary Email

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