Application to Great Southern Travel's Independent Contractor Program

If you prefer to fill out the application and send it to us via Fax, Mail, or dropping it at one of our offices; please download the application
Mailing Address: Great Southern Travel 3424 South National Springfield, MO 65807
Fax: 417-888-4482

Personal Information:
     
 
First Name:
 
Last Name:
     
 
Business Name:
Mailing Address (Home): (No PO Box Please)
 
Street:
 
City:
  
 
State:
  
 
Zip Code:
 
Mailing Address (Business): Same as above  
 
Street:
  
 
City:
  
 
State:
  
 
Zip Code:
 
       
 
Home Phone:
- -  
 
Business Phone:
- -  
 
Cell Phone:
- -  
 
Fax Number:
- -  
 
   
 
Email:
       
Is your business a corporation?
 
Level of Experience:
 
Do you book group travel?
 
Projected Annual Gross Sales:
 
     
Type of Business you will be targeting? (Please check all that apply)
 

Leisure (Cruises, Tours, & Packages)

  Groups
  Corporate/Business Travel
  Weddings/Honeymoons
  Other (please explain)
 
Employment History:
(beginning with the most recent). Please give complete company name, phone number, dates of employment, and reason for separation (including non-travel):
Company Name:

Employment Dates:
From:     To:
Phone Number:
( ) - -
Reason for Separation:
 
Company Name:

Employment Dates:
From:     To:
Phone Number:
( ) - -
Reason for Separation:
 
Company Name:

Employment Dates:
From:     To:
Phone Number:
( ) - -
Reason for Separation:
 
Company Name:

Employment Dates:
From:     To:
Phone Number:
( ) - -
Reason for Separation:
 
Have you ever plead guilty to, or been convicted of, any criminal offense other than a minor traffic violation?
If "Yes" please explain (include Charge; City, State; Date; and result):
How did you hear about us?
   
   
Please print, sign and return this Disclosure / Authorization form - Click Here