TRAVEL EMPLOYMENT RECORD
PRESENT EMPLOYMENT:
Company Name
Job Title
Street Address
City/State/Zip
Company Phone
Immediate Supervisor
Supervisor's Phone
Employment Dates	From: To:
Reason for Leaving
Annual Base Salary	(hourly if part-time)
Duties - Promotions - Supervisory Experience
PAST TRAVEL EMPLOYMENT:
Company Name
Job Title
Street Address
City/State/ZIP
Company Phone
Immediate Supervisor
Supervisor's Phone
Employment Dates	From: To:
Reason for Leaving
Annual Base Salary	(hourly if part-time)
Duties - Promotions - Supervisory Experience

EDUCATION AND TRAINING
High School	Location	Yrs Attended	Graduate?
			Yes No
College/University	Location	Yrs Attended	Graduate?
			Yes No
Travel/Trade School	No of Hours	Dates	Subject

Special Course	No of Hours	Dates	Subject

GENERAL INFORMATION
Are you legally eligible for self-employment in the United States?	Yes No
Have you been convicted of a felony within the last 5 years?	Yes No
How did you hear of TEC Affiliates?
List any friends or relatives working for Travel Express Corp. (specify relationship):
Have you ever worked for Travel Express Corp.?	Yes No
If so when?

In consideration of my affiliation with Travel Express Corp., I acknowledge that my affiliation with Travel Express Corp. is at will and with a clear understanding of the guidelines and restrictions of affiliation with Travel Express Corp., that must be adhered to and followed. Therefore my affiliation can be terminated, with or without notice, at any time, at the option of Travel Express Corp. if the affiliation guidelines and restrictions are not followed. I understand that no representative of Travel Express Corp. other than the president has any authority to enter into any agreement for affiliation for any specified period of time or to make any agreement contrary to the foregoing, and any representations contrary to the foregoing are expressly disavowed, shall not be binding upon Travel Express Corp. and should not be relied upon by any prospective or existing affiliate, unless made in writing and signed by the president. I further acknowledge that any Travel Express Corp. personnel manual, handbook, publication, policy, procedure, rule or regulation that may now or in the future apply to me is not contractual in nature and is not intended to modify the foregoing affiliate relationship, unless stated in writing and signed by the president.

In recognition of my affiliation with Travel Express Corp., I agree: (1) to keep confidential all information obtained while working as a affiliate for Travel Express Corp., including all that relates to clients, including all personal data in profiles and reservation and ticket information; (2) not to reveal or provide to any competitor or potential competitor any of Travel Express Corp. client names, prospect names, sales material, or other data that could damage Travel Express Corp. competitive position in the marketplace; (3) to refrain from soliciting Travel Express Corp. clients or employees or assisting others to solicit Travel Express Corp. clients or employees within 12 months after I leave Travel Express Corp. for whatever reason; and (4) to refrain for 12 months after I leave Travel Express Corp. for any reason (or no reason) from providing travel services to any client on which I spent a significant amount of my time as an affiliate of Travel Express Corp. (Item 4 does not apply to affiliates who were working directly for the client prior to Travel Express Corp. obtaining that client)

I agree that all the foregoing information is true and correct to the best of my knowledge and belief. In the event that any of the above information is false or there is a material ommission, it may be grounds for immediate refusal of my affiliation with Travel Express Corp.. I authorize Travel Express Corp. to contact my previous and current employers and personal references for verifacation. (If there are any restrictions, they must be noted here.)