Agent account application

Security statement: due to the recent hit library is rampant attack, please do not use the same or similar with other web site username, password, and as a result of your intent or negligence, cause your user name password leak in this system, the effects on the business shall be borne by you, safety hazards to our system, the system owner will reserve the right to further shall be investigated for legal responsibility.
*Agent's Name
Please entry correct applicant full name on Business License.
*Agency Legal representative
Please entry correct applicant Legal representative on Business License.
*belong to sale dept
Please select city belong to your company sale office located according
User type
*City
*Contact
*tel
You will recieve SMS information to verify, after verified, Formate: XXXXXXXXXXX
*Phone number
Formate: 0XX(X)-xxxxxxx(x)
*Email
You will recieve email to verify, after verified, Example: xxx@xxx.com
*Post address
Please entry correct mail address
Post Code
FAX
Whether the BSP Agent?
BSP Agent require fill the correct Office number and IATA Code, None BSP agent please select " No"
*OfficeCode
*IATANO
IATA No is 8 digit Number
*Bank account name
Bank account name can not more then 100 characters
*Bank name
Bank of deposit cannot exceed 100 characters
*Account info
Please fill Bank account information
Currency
*B2BUser name
Must be combined by letter + number
*Entry account password
The password must be 6-20 digits, number, letters, symbols component at least two kind appear
*Confirm account password
Please upload bellow information each one picture, Business License, Organization code certificate, passenger qualification certificate, legal representative ID card copy, picture format (gif, jpg, png, bmp)
*upload image
Select file
Remark
Code