NexCite Registration Form Complete the form below to create a NexCite Express account. If you have questions or need assistance to complete this form, please call (503) 626-7766 ext 304 or email sales@passportonlineinc.com. Note: If you have already signed up with us by phone, you do not need to use this form.

Step 1 of 3: Agency Web Site Contact Information:

Items marked with (*) are required. Company Information Please enter the information for the company who will own this NexCite Express account. This information is not displayed to customers. Company Name:* Address:* City:* State/Province:* Postal Code:* Country:* Company Telephone Number:* Company Fax Number: IATA/ARC/CLIA:* Affiliations: Contact Person Information Please enter the information for the person who will serve as the primary contact for this account. This information will not be displayed to customers. An account for access to the NexCite express tools will be created for this individual. Salutation: Mr. Mrs. Ms. Dr. Rev. First Name:* Last Name:* Your Position at Company: Your Email Address:* Your Telephone Number:* Your Fax Number: How did you hear about NexCite Express? Site Branding Information This is information that will be used to create and configure your NexCite Express website. This information will be displayed to customers. Company Display Name:* Website Address:* http://.vacationport.net Email Address for Customer Inquiries:* Customer Service and Sales Telephone Number:* Customer Service Fax Number: State Licensing Number or other Seller of Travel Information:

Step 2 of 3: NexCite Layout (select one):

Top Menu Navigation Left Side Menu Navigation

Step 3 of 3: Billing Information

Once this form has been submitted, a Passport Online representative will call you to confirm billing information and complete your order.