<%
' FP_ASP ASP Automatically generated by a Frontpage Component. Do not Edit.
On Error Resume Next
Session("FP_OldCodePage") = Session.CodePage
Session("FP_OldLCID") = Session.LCID
Session.CodePage = 1252
Err.Clear

strErrorUrl = ""

If Request.ServerVariables("REQUEST_METHOD") = "POST" Then
If Request.Form("VTI-GROUP") = "0" Then
	Err.Clear

	Set fp_conn =  Server.CreateObject("ADODB.Connection")
	FP_DumpError strErrorUrl, "Cannot create connection"

	Set fp_rs = Server.CreateObject("ADODB.Recordset")
	FP_DumpError strErrorUrl, "Cannot create record set"

	fp_conn.Open Application("orderkit_ConnectionString")
	FP_DumpError strErrorUrl, "Cannot open database"

	fp_rs.Open "Results", fp_conn, 1, 3, 2 ' adOpenKeySet, adLockOptimistic, adCmdTable
	FP_DumpError strErrorUrl, "Cannot open record set"

	fp_rs.AddNew
	FP_DumpError strErrorUrl, "Cannot add new record set to the database"
	Dim arFormFields0(50)
	Dim arFormDBFields0(50)
	Dim arFormValues0(50)

	arFormFields0(0) = "Referral"
	arFormDBFields0(0) = "Referral"
	arFormValues0(0) = Request("Referral")
	arFormFields0(1) = "ARCyes"
	arFormDBFields0(1) = "ARCyes"
	arFormValues0(1) = Request("ARCyes")
	arFormFields0(2) = "ARCno"
	arFormDBFields0(2) = "ARCno"
	arFormValues0(2) = Request("ARCno")
	arFormFields0(3) = "FullTimeYES"
	arFormDBFields0(3) = "FullTimeYES"
	arFormValues0(3) = Request("FullTimeYES")
	arFormFields0(4) = "E_mail"
	arFormDBFields0(4) = "E_mail"
	arFormValues0(4) = Request("E_mail")
	arFormFields0(5) = "Phone_time"
	arFormDBFields0(5) = "Phone_time"
	arFormValues0(5) = Request("Phone_time")
	arFormFields0(6) = "TravelSchoolState"
	arFormDBFields0(6) = "TravelSchoolState"
	arFormValues0(6) = Request("TravelSchoolState")
	arFormFields0(7) = "OutsideNO"
	arFormDBFields0(7) = "OutsideNO"
	arFormValues0(7) = Request("OutsideNO")
	arFormFields0(8) = "Street"
	arFormDBFields0(8) = "Street"
	arFormValues0(8) = Request("Street")
	arFormFields0(9) = "First_Name"
	arFormDBFields0(9) = "First_Name"
	arFormValues0(9) = Request("First_Name")
	arFormFields0(10) = "Mail_Kit"
	arFormDBFields0(10) = "Mail_Kit"
	arFormValues0(10) = Request("Mail_Kit")
	arFormFields0(11) = "cliaYears"
	arFormDBFields0(11) = "cliaYears"
	arFormValues0(11) = Request("cliaYears")
	arFormFields0(12) = "cliaNO"
	arFormDBFields0(12) = "cliaNO"
	arFormValues0(12) = Request("cliaNO")
	arFormFields0(13) = "Experience"
	arFormDBFields0(13) = "Experience"
	arFormValues0(13) = Request("Experience")
	arFormFields0(14) = "Phone_type2"
	arFormDBFields0(14) = "Phone_type2"
	arFormValues0(14) = Request("Phone_type2")
	arFormFields0(15) = "Agency_name"
	arFormDBFields0(15) = "Agency_name"
	arFormValues0(15) = Request("Agency_name")
	arFormFields0(16) = "What_do_you_do_now"
	arFormDBFields0(16) = "What_do_you_do_now"
	arFormValues0(16) = Request("What_do_you_do_now")
	arFormFields0(17) = "Title"
	arFormDBFields0(17) = "Title"
	arFormValues0(17) = Request("Title")
	arFormFields0(18) = "Agent_name"
	arFormDBFields0(18) = "Agent_name"
	arFormValues0(18) = Request("Agent_name")
	arFormFields0(19) = "TravelSchoolCity"
	arFormDBFields0(19) = "TravelSchoolCity"
	arFormValues0(19) = Request("TravelSchoolCity")
	arFormFields0(20) = "cliaYES"
	arFormDBFields0(20) = "cliaYES"
	arFormValues0(20) = Request("cliaYES")
	arFormFields0(21) = "Phone1"
	arFormDBFields0(21) = "Phone1"
	arFormValues0(21) = Request("Phone1")
	arFormFields0(22) = "Search_engine"
	arFormDBFields0(22) = "Search_engine"
	arFormValues0(22) = Request("Search_engine")
	arFormFields0(23) = "YearsOutside"
	arFormDBFields0(23) = "YearsOutside"
	arFormValues0(23) = Request("YearsOutside")
	arFormFields0(24) = "OutsideYes"
	arFormDBFields0(24) = "OutsideYes"
	arFormValues0(24) = Request("OutsideYes")
	arFormFields0(25) = "Phone2"
	arFormDBFields0(25) = "Phone2"
	arFormValues0(25) = Request("Phone2")
	arFormFields0(26) = "Company"
	arFormDBFields0(26) = "Company"
	arFormValues0(26) = Request("Company")
	arFormFields0(27) = "Book"
	arFormDBFields0(27) = "Book"
	arFormValues0(27) = Request("Book")
	arFormFields0(28) = "Where_run_business"
	arFormDBFields0(28) = "Where_run_business"
	arFormValues0(28) = Request("Where_run_business")
	arFormFields0(29) = "YearsFullTime"
	arFormDBFields0(29) = "YearsFullTime"
	arFormValues0(29) = Request("YearsFullTime")
	arFormFields0(30) = "Last_name"
	arFormDBFields0(30) = "Last_name"
	arFormValues0(30) = Request("Last_name")
	arFormFields0(31) = "Agent_id_number"
	arFormDBFields0(31) = "Agent_id_number"
	arFormValues0(31) = Request("Agent_id_number")
	arFormFields0(32) = "Agency_id_number"
	arFormDBFields0(32) = "Agency_id_number"
	arFormValues0(32) = Request("Agency_id_number")
	arFormFields0(33) = "Extension"
	arFormDBFields0(33) = "Extension"
	arFormValues0(33) = Request("Extension")
	arFormFields0(34) = "City"
	arFormDBFields0(34) = "City"
	arFormValues0(34) = Request("City")
	arFormFields0(35) = "Middle_initial"
	arFormDBFields0(35) = "Middle_initial"
	arFormValues0(35) = Request("Middle_initial")
	arFormFields0(36) = "Newspaper"
	arFormDBFields0(36) = "Newspaper"
	arFormValues0(36) = Request("Newspaper")
	arFormFields0(37) = "Magazine"
	arFormDBFields0(37) = "Magazine"
	arFormValues0(37) = Request("Magazine")
	arFormFields0(38) = "Source"
	arFormDBFields0(38) = "Source"
	arFormValues0(38) = Request("Source")
	arFormFields0(39) = "ARCyears"
	arFormDBFields0(39) = "ARCyears"
	arFormValues0(39) = Request("ARCyears")
	arFormFields0(40) = "FullTimeNO"
	arFormDBFields0(40) = "FullTimeNO"
	arFormValues0(40) = Request("FullTimeNO")
	arFormFields0(41) = "YearGraduated"
	arFormDBFields0(41) = "YearGraduated"
	arFormValues0(41) = Request("YearGraduated")
	arFormFields0(42) = "Other"
	arFormDBFields0(42) = "Other"
	arFormValues0(42) = Request("Other")
	arFormFields0(43) = "Zip"
	arFormDBFields0(43) = "Zip"
	arFormValues0(43) = Request("Zip")
	arFormFields0(44) = "TravelSchoolPhone"
	arFormDBFields0(44) = "TravelSchoolPhone"
	arFormValues0(44) = Request("TravelSchoolPhone")
	arFormFields0(45) = "Country"
	arFormDBFields0(45) = "Country"
	arFormValues0(45) = Request("Country")
	arFormFields0(46) = "Website"
	arFormDBFields0(46) = "Website"
	arFormValues0(46) = Request("Website")
	arFormFields0(47) = "TravelSchool"
	arFormDBFields0(47) = "TravelSchool"
	arFormValues0(47) = Request("TravelSchool")
	arFormFields0(48) = "State"
	arFormDBFields0(48) = "State"
	arFormValues0(48) = Request("State")
	arFormFields0(49) = "Suffix"
	arFormDBFields0(49) = "Suffix"
	arFormValues0(49) = Request("Suffix")

	FP_SaveFormFields fp_rs, arFormFields0, arFormDBFields0

	If Request.ServerVariables("HTTP_USER_AGENT") <> "" Then
		FP_SaveFieldToDB fp_rs, Request.ServerVariables("HTTP_USER_AGENT"), "Browser_type"
	End If
	If Request.ServerVariables("REMOTE_HOST") <> "" Then
		FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_HOST"), "Remote_computer_name"
	End If
	FP_SaveFieldToDB fp_rs, Now, "Timestamp"
	If Request.ServerVariables("REMOTE_USER") <> "" Then
		FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_USER"), "User_name"
	End If

	fp_rs.Update
	FP_DumpError strErrorUrl, "Cannot update the database"

	fp_rs.Close
	fp_conn.Close

	Session("FP_SavedFields")=arFormFields0
	Session("FP_SavedValues")=arFormValues0
	Session.CodePage = Session("FP_OldCodePage")
	Session.LCID = Session("FP_OldLCID")
	Response.Redirect "http://www.protix.org/infokit/confirmEkit.htm"

End If
End If

Session.CodePage = Session("FP_OldCodePage")
Session.LCID = Session("FP_OldLCID")

%>
<!DOCTYPE HTML PUBLIC "-//IETF//DTD HTML//EN">

<html>

<head>
<meta name="GENERATOR" content="Microsoft FrontPage 4.0">
<meta name="ProgId" content="FrontPage.Editor.Document">
<title>Business Opportunity - Start your own travel and ticket
agency.&nbsp; Homebased, store front, existing business.
Part-time or full time.</title>
<base target="bottom">
<meta name="Microsoft Border" content="none">
</head>

<body>
        <table border="0" width="100%">
            <tr>
                <td width="100%">
                                        <img border="0" src="../images/protix_spin.gif"></td>
            </tr>
            <tr>
                <td width="100%"><font color="#800080"><b><font face="Arial">Register
                  for your free information kit.<br>
                  </font>
                  </b><font face="Arial" size="3"><b>Complete
                  this form and tour our information kit online now.</b></font></font><small><font
                            face="Arial"><strong><br>
                  Fields in <font
                            color="#FF0000">RED</font> are
                            required.</strong></font></small></td>
            </tr>
            <tr>
                <td width="100%" bgcolor="#FFFFFF" valign="top"><!--webbot BOT="GeneratedScript" PREVIEW=" " startspan --><script Language="JavaScript" Type="text/javascript"><!--
function FrontPage_Form1_Validator(theForm)
{

  if (theForm.First_Name.value == "")
  {
    alert("Please enter a value for the \"Enter your first name\" field.");
    theForm.First_Name.focus();
    return (false);
  }

  if (theForm.Last_name.value == "")
  {
    alert("Please enter a value for the \"Enter your last name\" field.");
    theForm.Last_name.focus();
    return (false);
  }

  if (theForm.Street.value == "")
  {
    alert("Please enter a value for the \"Enter your street address\" field.");
    theForm.Street.focus();
    return (false);
  }

  if (theForm.City.value == "")
  {
    alert("Please enter a value for the \"Enter your city\" field.");
    theForm.City.focus();
    return (false);
  }

  if (theForm.State.value == "")
  {
    alert("Please enter a value for the \"Enter your state\" field.");
    theForm.State.focus();
    return (false);
  }

  if (theForm.Zip.value == "")
  {
    alert("Please enter a value for the \"Enter your zip code\" field.");
    theForm.Zip.focus();
    return (false);
  }

  if (theForm.Phone1.value == "")
  {
    alert("Please enter a value for the \"Enter your area code and phone number\" field.");
    theForm.Phone1.focus();
    return (false);
  }

  if (theForm.Phone_time.selectedIndex < 0)
  {
    alert("Please select one of the \"Choose your best contact time\" options.");
    theForm.Phone_time.focus();
    return (false);
  }

  if (theForm.Phone_time.selectedIndex == 0)
  {
    alert("The first \"Choose your best contact time\" option is not a valid selection.  Please choose one of the other options.");
    theForm.Phone_time.focus();
    return (false);
  }

  if (theForm.E_mail.value == "")
  {
    alert("Please enter a value for the \"Enter your complete email address\" field.");
    theForm.E_mail.focus();
    return (false);
  }

  if (theForm.E_mail.value.length < 5)
  {
    alert("Please enter at least 5 characters in the \"Enter your complete email address\" field.");
    theForm.E_mail.focus();
    return (false);
  }

  if (theForm.Experience.selectedIndex < 0)
  {
    alert("Please select one of the \"Do you have experience being a travel agent?\" options.");
    theForm.Experience.focus();
    return (false);
  }

  if (theForm.Experience.selectedIndex == 0)
  {
    alert("The first \"Do you have experience being a travel agent?\" option is not a valid selection.  Please choose one of the other options.");
    theForm.Experience.focus();
    return (false);
  }

  if (theForm.Where_run_business.selectedIndex == 0)
  {
    alert("The first \"Where do you plan on running your business\" option is not a valid selection.  Please choose one of the other options.");
    theForm.Where_run_business.focus();
    return (false);
  }

  if (theForm.Source.selectedIndex < 0)
  {
    alert("Please select one of the \"Choose how you heard of our company\" options.");
    theForm.Source.focus();
    return (false);
  }

  if (theForm.Source.selectedIndex == 0)
  {
    alert("The first \"Choose how you heard of our company\" option is not a valid selection.  Please choose one of the other options.");
    theForm.Source.focus();
    return (false);
  }
  return (true);
}
//--></script><!--webbot BOT="GeneratedScript" endspan --><form
                method="POST"
                action="orderkit.asp"
                onsubmit="return FrontPage_Form1_Validator(this)"
                name="FrontPage_Form1" webbot-action="--WEBBOT-SELF--" language="JavaScript">
                    <!--webbot bot="SaveDatabase" startspan SuggestedExt="asp"
                    U-ASP-Include-Url="../_fpclass/fpdbform.inc"
                    S-DataConnection="orderkit" S-RecordSource="Results"
                    U-Database-URL="../fpdb/orderkit.mdb"
                    U-Confirmation-Url="http://www.protix.org/infokit/confirmEkit.htm"
                    S-Builtin-Fields="HTTP_USER_AGENT REMOTE_HOST Timestamp REMOTE_USER"
                    S-Builtin-DBFields="Browser_type Remote_computer_name Timestamp User_name"
                    S-Form-Fields="Referral ARCyes ARCno FullTimeYES E_mail Phone_time TravelSchoolState OutsideNO Street First_Name Mail_Kit cliaYears cliaNO Experience Phone_type2 Agency_name What_do_you_do_now Title Agent_name TravelSchoolCity cliaYES Phone1 Search_engine YearsOutside OutsideYes Phone2 Company Book Where_run_business YearsFullTime Last_name Agent_id_number Agency_id_number Extension City Middle_initial Newspaper Magazine Source ARCyears FullTimeNO YearGraduated Other Zip TravelSchoolPhone Country Website TravelSchool State Suffix"
                    S-Form-DBFields="Referral ARCyes ARCno FullTimeYES E_mail Phone_time TravelSchoolState OutsideNO Street First_Name Mail_Kit cliaYears cliaNO Experience Phone_type2 Agency_name What_do_you_do_now Title Agent_name TravelSchoolCity cliaYES Phone1 Search_engine YearsOutside OutsideYes Phone2 Company Book Where_run_business YearsFullTime Last_name Agent_id_number Agency_id_number Extension City Middle_initial Newspaper Magazine Source ARCyears FullTimeNO YearGraduated Other Zip TravelSchoolPhone Country Website TravelSchool State Suffix" --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--#include file="../_fpclass/fpdbform.inc"--><!--webbot
                    bot="SaveDatabase" endspan i-checksum="34604" -->
  <p class="MsoNormal">
  <img border="0" src="../images/step1.gif"></p>
  <table border="0" cellspacing="0" cellpadding="0" width="491" style="mso-cellspacing: 0in; mso-padding-alt: 2.25pt 2.25pt 2.25pt 2.25pt">
    <tr>
      <td width="483" colspan="2" style="background-color: #FFCC00; background-repeat: repeat; background-attachment: scroll; padding: 2.25pt; background-position: 0% 50%" bgcolor="#800080">
        <p class="MsoNormal"><b><font color="#800080" size="4"><span style="font-family: Arial">Contact
        Info&nbsp;</span></font></b>
      </td>
    </tr>
    <tr>
      <td valign="middle" style="padding: 2.25pt" width="98">
        <p class="MsoNormal"><small><strong><font face="Arial">Name:</font></strong></small></o:p>
        </p>
      </td>
      <td style="padding: 2.25pt" width="377">
        <table border="0" width="100%">
          <tr>
            <td width="20%"><font size="2">Title</font></td>
            <td width="20%"><font size="2" color="#FF0000"><b>First</b></font></td>
            <td width="20%"><font size="2">Middle</font></td>
            <td width="20%"><font size="2" color="#FF0000"><b>Last</b></font></td>
            <td width="20%"><font size="2">Suffix</font></td>
          </tr>
          <tr>
            <td width="20%"><select size="1" name="Title">
                <option>CHOOSE</option>
                <option>DR</option>
                <option>MR</option>
                <option>MS</option>
                <option>MISS</option>
                <option>MRS</option>
              </select></td>
            <td width="20%"><font
                            face="Arial"><small><!--webbot bot="Validation"
              S-Display-Name="Enter your first name" B-Value-Required="TRUE" --><input type="text" name="First_Name" size="22" tabindex="2"></small> </font></td>
            <td width="20%">
              <p align="center"><font
                            face="Arial"><small><input type="text" name="Middle_initial" size="2" tabindex="3"></small> </font></td>
            <td width="20%"><!--webbot bot="Validation"
              S-Display-Name="Enter your last name" B-Value-Required="TRUE" --><input type="text" name="Last_name" size="18" tabindex="4"></td>
            <td width="20%"><select size="1" name="Suffix" tabindex="5">
                <option>CHOOSE</option>
                <option>JR</option>
                <option>SR</option>
                <option value="I">I</option>
                <option value="II">II</option>
                <option value="III">III</option>
                <option value="IV">IV</option>
              </select></td>
          </tr>
        </table>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="98">
        <p class="MsoNormal"><font face="Arial"><b><small>Company:&nbsp;</small></b></font></p>
      </td>
      <td style="padding: 2.25pt" width="377">
        <input type="text" name="Company" size="29" tabindex="6">
      </td>
    </tr>
    <tr>
      <td valign="middle" style="padding: 2.25pt" width="98">
        <p class="MsoNormal"><font face="Arial"><b><small>Address:</small></b></font></p>
      </td>
      <td valign="top" style="padding: 2.25pt" width="377">
        <table border="0" width="100%">
          <tr>
            <td width="80%" colspan="4"><font size="2" color="#FF0000"><b>Street
              Address</b></font></td>
          </tr>
          <tr>
            <td width="80%" colspan="4"><!--webbot bot="Validation"
              S-Display-Name="Enter your street address" B-Value-Required="TRUE"
              --><input type="text" name="Street" size="55" tabindex="7"></td>
          </tr>
          <tr>
            <td width="20%"><font size="2" color="#FF0000"><b>City</b></font></td>
            <td width="20%"><font size="2" color="#FF0000"><b>State</b></font></td>
            <td width="20%"><font size="2" color="#FF0000"><b>Zip Code</b></font></td>
            <td width="20%"><font size="2">Country</font></td>
          </tr>
          <tr>
            <td width="20%"><font
                            face="Arial"><small><!--webbot bot="Validation"
              S-Display-Name="Enter your city" B-Value-Required="TRUE" --><input type="text" name="City" size="22" tabindex="8"></small> </font></td>
            <td width="20%"><font
                            face="Arial"><small><!--webbot bot="Validation"
              S-Display-Name="Enter your state" B-Value-Required="TRUE" --><input type="text" name="State" size="3" tabindex="9"></small> </font></td>
            <td width="20%"><!--webbot bot="Validation"
              S-Display-Name="Enter your zip code" B-Value-Required="TRUE" --><input type="text" name="Zip" size="18" tabindex="10"></td>
            <td width="20%">
        <font
                            face="Arial">
        <small><input type="text"
                            name="Country"
                            size="5" tabindex="11"></small></font>
            </td>
          </tr>
        </table>
      </td>
    </tr>
    <tr>
      <td valign="middle" style="padding: 2.25pt" width="98">
        <font face="Arial"><b><small>Phone:</small></b></font>
      </td>
      <td valign="top" style="padding: 2.25pt" width="377">
        <table border="0" width="100%">
          <tr>
            <td width="20%"><font size="2" color="#FF0000"><b>Phone</b></font></td>
            <td width="20%"><font size="2">Ext.</font></td>
            <td width="20%"><font size="2" color="#FF0000"><b>Time</b></font></td>
            <td width="10%"><font size="2">Other Phone</font></td>
            <td width="10%"><font size="2">Type</font></td>
          </tr>
          <tr>
            <td width="20%"><!--webbot bot="Validation"
              S-Display-Name="Enter your area code and phone number"
              B-Value-Required="TRUE" --><input NAME="Phone1" size="20" tabindex="12"> </td>
            <td width="20%">
        <input MAXLENGTH="50" SIZE="4" NAME="Extension" tabindex="13"> </td>
            <td width="20%"><!--webbot bot="Validation"
              S-Display-Name="Choose your best contact time"
              B-Value-Required="TRUE" B-Disallow-First-Item="TRUE" --><select size="1" name="Phone_time" tabindex="14">
                <option>Choose</option>
                <option>Day</option>
                <option>Eve</option>
              </select></td>
            <td width="10%">
        <font
                            face="Arial">
        <small><input type="text"
                            name="Phone2"
                            size="17" tabindex="15"></small></font>
            </td>
            <td width="10%"><select size="1" name="Phone_type2" tabindex="16">
                <option>Choose</option>
                <option>Day</option>
                <option>Eve</option>
                <option>Fax</option>
                <option>Cell</option>
                <option>Pager</option>
              </select></td>
          </tr>
        </table>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="98">
        <p class="MsoNormal"><span style="font-size:10.0pt;font-family:Arial"><b><font color="#FF0000">E-Mail:</font></b></span></p>
      </td>
      <td valign="top" style="padding: 2.25pt" width="377">
        <!--webbot bot="Validation"
        S-Display-Name="Enter your complete email address"
        B-Value-Required="TRUE" I-Minimum-Length="5" --><input SIZE="50" NAME="E_mail" tabindex="17">
      </td>
    </tr>
  </table>
  <p class="MsoNormal"><img border="0" src="../images/step2.gif">
 </p>
  <table border="0" cellspacing="0" cellpadding="0" width="580" style="mso-cellspacing: 0in; mso-padding-alt: 2.25pt 2.25pt 2.25pt 2.25pt">
    <tr>
      <td width="572" style="background-color: #FFCC00; background-repeat: repeat; background-attachment: scroll; padding: 2.25pt; background-position: 0% 50%" bgcolor="#800080">
        <p class="MsoNormal"><b><font color="#660066"><span style="font-family: Arial"><font size="4">Experience</font></span></font><span style="font-family: Arial"><font size="4"></font><font size="4" color="#800080">&nbsp;</font></span></b>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="564">
        <font
                                        face="Arial"><b><small>Membership in </small><small>the
        </small><small>ProTIX Agent Support Network is only open to </small><small>experienced</small><small>
        travel agents or travel school graduates.</small></b><small>&nbsp;<br>
        <br>
        </small></font>
        <font
                            face="Arial"><small><b><img border="0" src="../images/stop.jpg" width="26" height="23" align="absmiddle">
                              </b></small> <a href="http://www.tixtravel.com" target="_blank"><small>If you
        are not an experienced
                              travel agent or travel school graduate, click here.<br>
        </small></a></font>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="564">
        <font color="#FF0000"
                            face="Arial"><b><small>Are you currently
                            or have you ever been a travel agent,<br>
        &nbsp;or travel school graduate? </small></b></font><!--webbot
        bot="Validation"
        S-Display-Name="Do you have experience being a travel agent?"
        B-Value-Required="TRUE" B-Disallow-First-Item="TRUE" --><select
                            name="Experience" size="1"
                            tabindex="18">
                                <option>Choose One</option>
                                <option>No</option>
                                <option>Yes</option>
                              </select> 
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="564">
        <table border="0" width="100%">
          <tr>
            <td width="16%"><font face="Arial"><b><small>Travel Agent </small><small>Experience:</small></b></font>
            </td>
            <td width="84%">
                              <table border="0" width="100%">
                                <tr>
                                  <td width="35%">I am a full-time agent:</td>
                                  <td width="65%" valign="middle"><input type="checkbox" name="FullTimeNO" value="FullTimeNO" tabindex="19">No
                                    <input type="checkbox" name="FullTimeYES" value="FullTimeYes" tabindex="20">Yes
                                    Years Experience <input type="text" name="YearsFullTime" size="8" tabindex="21"></td>
                                </tr>
                                <tr>
                                  <td width="35%">I am an outside agent:</td>
                                  <td width="65%" valign="middle"><input type="checkbox" name="OutsideNO" value="OutsideNo" tabindex="22">No
                                    <input type="checkbox" name="OutsideYes" value="OutsideYES" tabindex="23">Yes
                                    Years Experience <input type="text" name="YearsOutside" size="8" tabindex="24"></td>
                                </tr>
                                <tr>
                                  <td width="35%">I own an ARC agency:</td>
                                  <td width="65%" valign="middle"><input type="checkbox" name="ARCno" value="ARC_NO" tabindex="25">No
                                    <input type="checkbox" name="ARCyes" value="ARC_YES" tabindex="26">Yes
                                    Years Experience <input type="text" name="ARCyears" size="8" tabindex="27"></td>
                                </tr>
                                <tr>
                                  <td width="35%">I own a CLIA agency:</td>
                                  <td width="65%" valign="middle"><input type="checkbox" name="cliaNO" value="Clia_No" tabindex="28">No
                                    <input type="checkbox" name="cliaYES" value="CliaYES" tabindex="29">Yes
                                    Years Experience <input type="text" name="cliaYears" size="8" tabindex="30"></td>
                                </tr>
                              </table>
            </td>
          </tr>
        </table>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="564">
        <table border="0" width="100%">
          <tr>
            <td width="17%"><font face="Arial"><b><small>Travel School
              Information</small><small>:</small></b></font>
            </td>
            <td width="83%">
                              <table border="0" width="100%">
                                <tr>
                                  <td width="25%" align="right"><font face="Arial" size="2">Name
                                    of school:</font></td>
                                  <td width="75%"><input type="text" name="TravelSchool" size="20" tabindex="31"></td>
                                </tr>
                                <tr>
                                  <td width="25%" align="right"><font face="Arial" size="2">City:</font></td>
                                  <td width="75%"><input type="text" name="TravelSchoolCity" size="20" tabindex="32"></td>
                                </tr>
                                <tr>
                                  <td width="25%" align="right"><font face="Arial" size="2">State:</font></td>
                                  <td width="75%"><input type="text" name="TravelSchoolState" size="20" tabindex="33"></td>
                                </tr>
                                <tr>
                                  <td width="25%" align="right"><font size="2" face="Arial">Phone:</font></td>
                                  <td width="75%"><input type="text" name="TravelSchoolPhone" size="20" tabindex="34"></td>
                                </tr>
                                <tr>
                                  <td width="25%" align="right"><font face="Arial" size="2">Year
                                    graduated:</font></td>
                                  <td width="75%"><input type="text" name="YearGraduated" size="20" tabindex="35"></td>
                                </tr>
                              </table>
            </td>
          </tr>
        </table>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="564">
        <font
                            face="Arial"><small>Where do you plan on
                            operating your business from? </small></font><small><font
                            face="Arial"><!--webbot bot="Validation"
        S-Display-Name="Where do you plan on running your business"
        B-Disallow-First-Item="TRUE" --><select
                            name="Where_run_business" size="1"
                            tabindex="36">
                                <option
                                value="---choose one---">Choose One</option>
                                <option value="Home">Home</option>
                                <option value="Existing business">Existing
                                business</option>
                                <option value="New retail store">New retail
                                store</option>
                                <option
                                value="Company I work for">Company I work for</option>
                            </select></font></small> 
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" width="564">
        <font
                            face="Arial"><small>What kind of business or
                            work do you presently do?&nbsp; <input type="text" name="What_do_you_do_now" size="20" tabindex="37"></small></font> 
      </td>
    </tr>
  </table>
  <p class="MsoNormal"><img border="0" src="../images/step3.gif"></p>


  <table border="0" cellspacing="0" cellpadding="0" width="578" style="mso-cellspacing: 0in; mso-padding-alt: 2.25pt 2.25pt 2.25pt 2.25pt" height="80">
    <tr>
      <td width="570" colspan="2" style="background-color: #FFCC00; background-repeat: repeat; background-attachment: scroll; padding: 2.25pt; background-position: 0% 50%" height="1">
        <p class="MsoNormal"><b><font color="#660066" size="4"><span style="font-family: Arial">Source</span></font></b></p>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" height="22" width="570" colspan="2">
        <span style="font-size:10.0pt;font-family:Arial">Please tell us how you
        heard of our company</span>
      </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <font face="Arial" color="#FF0000"><small><b>Source:</b></small></font>
            </td>
            <td style="padding: 0in" width="495">
              <!--webbot bot="Validation"
              S-Display-Name="Choose how you heard of our company"
              B-Value-Required="TRUE" B-Disallow-First-Item="TRUE" --><select size="1" name="Source" tabindex="38">
                                <option>&gt;&gt;&gt;Choose&lt;&lt;&lt;</option>
                                <option>Select Search Engine------</option>
                                <option>AltaVista</option>
                                <option>AskJeeves</option>
                                <option>Excite</option>
                                <option>Go</option>
                                <option>Lycos</option>
                                <option>Yahoo</option>
                                <option>Other Search Engine Fill in Other box</option>
                                <option>Magazine------</option>
                                <option>Travel Agent</option>
                                <option>Travel Weekly</option>
                                <option>Leisure Travel News</option>
                                <option>Entreprenuer</option>
                                <option>Business Start Ups</option>
                                <option>Business Opportunities Handbook</option>
                                <option>Other Magazine Fill in other box</option>
                                <option>Book--------------------------</option>
                                <option>How to earn $30,000 with your home
                                computer</option>
                                <option>Other book fill in title in other box</option>
                                <option>Radio Fill in station and date/time in
                                other box</option>
                                <option>Television Fill in station date/time in
                                other box</option>
                              </select>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <span style="font-size: 10.0pt; font-family: Arial"><b>Magazine:</b></span>
            </td>
            <td style="padding: 0in" width="495">
              <small><font
                            face="Arial"><input type="text"
                            name="Magazine" size="20"
                            tabindex="39">Please provide name of magazine</font></small>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <span style="font-size: 10.0pt; font-family: Arial"><b>Search
              Engine:</b></span>
            </td>
            <td style="padding: 0in" width="495">
              <small><font
                            face="Arial"><input type="text"
                            name="Search_engine" size="20"
                            tabindex="40">Please provide name of search engine</font></small>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <font face="Arial"><small><b>Website:</b></small></font>
            </td>
            <td style="padding: 0in" width="495">
              <input type="text" name="Website" size="20" tabindex="41"><font face="Arial" size="2">Please
              provide website address</font>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <span style="font-size: 10.0pt; font-family: Arial"><b>Newspaper:</b></span>
            </td>
            <td style="padding: 0in" width="495">
              <small><font
                            face="Arial"><input type="text"
                            name="Newspaper" size="20"
                            tabindex="42">Please provide name of newspaper</font></small>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <font face="Arial"><small><b>Book:</b></small></font>
            </td>
            <td style="padding: 0in" width="495">
              <input type="text" name="Book" size="20" tabindex="43"><font face="Arial" size="2">Please
              provide name of book</font>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <span style="font-size: 10.0pt; font-family: Arial"><b>Referral:</b></span>
            </td>
            <td style="padding: 0in" width="495">
              <small><font
                            face="Arial"><input type="text"
                            name="Referral" size="20"
                            tabindex="44">Please provide persons name</font></small>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <span style="font-size: 10.0pt; font-family: Arial"><b>Other:</b></span>
            </td>
            <td style="padding: 0in" width="495">
              <small><font
                            face="Arial"><input type="text"
                            name="Other" size="20" tabindex="45">Please provide
              how you heard about us</font></small>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
              <span style="font-size: 10.0pt; font-family: Arial"><b>Agency:</b></span>
            </td>
            <td style="padding: 0in" width="495">
        <table border="0" cellspacing="0" cellpadding="0" style="mso-cellspacing:0in;
   mso-padding-alt:0in 0in 0in 0in">
          <tr>
            <td style="padding:0in 0in 0in 0in">
              <p class="MsoNormal"><span style="font-size: 10.0pt; font-family: Arial">Name</span><br>
              <input NAME="Agency_name" size="20" tabindex="46"></p>
            </td>
            <td style="padding:0in 0in 0in 0in">
              <p class="MsoNormal"><span style="font-size:10.0pt;font-family:Arial">&nbsp;ID
              #</span><br>
              <input MAXLENGTH="20" NAME="Agency_id_number" size="5" tabindex="47"></p>
            </td>
          </tr>
        </table>
            </td>
    </tr>
    <tr>
            <td style="padding: 0in" width="79">
        <span style="font-size: 10.0pt; font-family: Arial"><b>Agent:</b></span>
            </td>
            <td style="padding: 0in" width="495">
        <table border="0" cellspacing="0" cellpadding="0" style="mso-cellspacing:0in;
   mso-padding-alt:0in 0in 0in 0in">
          <tr>
            <td style="padding:0in 0in 0in 0in">
              <p class="MsoNormal"><span style="font-size: 10.0pt; font-family: Arial">Name</span><br>
              <input NAME="Agent_name" size="20" tabindex="48"></p>
            </td>
            <td style="padding:0in 0in 0in 0in">
              <p class="MsoNormal"><span style="font-size:10.0pt;font-family:Arial">&nbsp;ID
              #</span><br>
              <input MAXLENGTH="20" NAME="Agent_id_number" size="5" tabindex="49"></p>
            </td>
          </tr>
        </table>
            </td>
    </tr>
  </table>
 <p><img border="0" src="../images/step4.gif"></p>


  <table border="0" cellspacing="0" cellpadding="0" width="585" style="mso-cellspacing: 0in; mso-padding-alt: 2.25pt 2.25pt 2.25pt 2.25pt">
    <tr>
      <td width="577" style="background-color: #FFCC00; background-repeat: repeat; background-attachment: scroll; padding: 2.25pt; background-position: 0% 50%">
        <p class="MsoNormal"><b><font color="#660066" size="4"><span style="font-family: Arial">Submit</span></font></b></p>
      </td>
    </tr>
    <tr>
      <td valign="top" style="padding: 2.25pt" height="22" width="569">
        <font face="Arial" size="2">After you submit your registration, you will
        be able to tour our complete membership kit online.&nbsp;&nbsp;<br>
        You can also purchase your membership online 24 hours a day.<br>
        Would you also like us to mail you a kit? <select size="1" name="Mail_Kit" tabindex="50">
          <option selected value="No">No</option>
          <option value="Yes">Yes</option>
        </select><br>
        </font><input
                            type="submit" value="Submit"
                            name="Protix_Inquiry_form"
                            tabindex="51"><input type="reset"
                            value="Reset" name="B3" tabindex="52"><br>
        <font face="Arial">
                            <small>Thank you
                            for your interest in the ProTIX Agent Support
                            Network.&nbsp;&nbsp;</small></font>
      </td>
    </tr>
  </table>
                </form>
                </td>
            </tr>
        </table>
</body>
</html>