perksPlus_Tabs

PerksPlus application form

To help us determine if PerksPlus® will benefit your company, please complete and submit this form. A PerksPlus representative will process your information and respond to your request.

Fields marked with an asterisk (*) are required.

Company information

Company name*

Company headquarters address

Address 1 *

Address 2

City *

State/Province *

Zip/Postal Code *

FEIN number *

Fed tax payer ID without spaces or dashes.

Type of business *

Number of employees *

Number of travelers *

Primary departure airport code *

How did you hear about PerksPlus?*

Contact information

Contact name *

Company email address *

Business phone *

Extension

Direct phone

Mileage Plus number

Not a member, join online today.

Miles & More number

Not a member, join online today.

Do YOU manage or coordinate your organization's travel program?*

Yes No

Additional information

Does your company book travel online?*
Yes No

Which site(s) does your company book travel on?

What is your company's total air travel expenditure ?*

Enter annual expenditure

What is your company's potential United/Lufthansa expenditure?*

Enter annual expenditure

Does your company have any corporate agreements with United/Lufthansa currently in force?*
Yes No

Which corporate program/agreement do you have with United/Lufthansa?

Does your company use a travel agency?*
Yes No

Are YOU a travel agent or travel agency?*
Yes No

I have read and agree with the terms and conditions.*