Travel Agents - Sign Up to Sell Travel Guard

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Required Information	Optional Information
*Company Name:	Email Address:
First Name Last Name:	Agency ARC/CLIA number:
*Phone Number:	Consortium:
*Street Address:	Website/URL:
Street Address 2:	What is your annual leisure sales volume?
*City:	How many agents work in your office?
*State/Province:	Are you affiliated with a host agency?	Yes No
*Postal Code:	Host agency name:
*Country:	What GDS system are you using?
*Doing Business As:	Current Travel Insurance Provider:
	How did you hear about Travel Guard?
Yes, please send me valuable updates on new Travel Guard products and services. I understand Travel Guard will not share my email address with any third parties.

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Non insurance services are provided by Travel Guard.

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This plan provides insurance coverage that only applies during the covered trip. You may have coverage from other sources that provides you with similar benefits but may be subject to different restrictions depending upon your other coverages. You may wish to compare the terms of this policy with your existing life, health, home, and automobile insurance policies. If you have any questions about your current coverage, call your insurer or insurance agent or broker. Coverage is offered by Travel Guard Group, Inc (Travel Guard). California lic. no.0B93606, 3300 Business Park Drive, Stevens Point, WI 54482, www.travelguard.com. CA DOI toll free number: 213-897-8921. This is only a brief description of the coverage(s) available. The Policy will contain reductions, limitations, exclusions and termination provisions. Insurance underwritten by National Union Fire Insurance Company of Pittsburgh, Pa., a Pennsylvania insurance company, with its principal place of business at 175 Water Street, 18th Floor, New York, NY 10038. It is currently authorized to transact business in all states and the District of Columbia. NAIC No. 19445. Coverage may not be available in all states. Your travel retailer may not be licensed to sell insurance, and cannot answer technical questions about the benefits, exclusions, and conditions of this insurance and cannot evaluate the adequacy of your existing insurance. Travel assistance services provided by Travel Guard.

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