Become a Group Leader

Group Leader Application Form Please complete the form below. Once you are finished, you must agree to the terms and conditions and press the Proceed button at the bottom of the page. * indicates a required field.

Your Group
Choose a name for your Group: *
eg: Mike's Touch Football Team
eg: The London Arms Ozzy Club 		Make sure you fill this field out properly so that the people you are promoting Winter Break 2010 to can find the correct group.
Approximate group size: * How many people do you think will come as part of your group?
Personal Details
Name: *  
Email Address: * It is very important you enter a valid email address, as this is normally how we will contact you.
Confirm Email: *
Secondary Email: You may supply a secondary email address as a backup, incase we cannot contact you on your primary address.
Mobile: * Please enter your mobile number, or the number we are best contacting you on.
Secondary Telephone: An additional phone number we can try if the one above does not work.
Mailing Address: *  
City: *  
Post Code: *  
Additional Names and Contact Details: If there are other people who will be helping you promote Winter Break 2010, enter their names, email addresses and telephone numbers here.
Bank Details for Commission Payments
Name of Account Holder *  
Sort Code: *  
Account Number: *  
Website Settings
Type of Home Page: * Personalised: You can have a home page for your group which you can customise with pictures, news and other information. A great way to drive sales through.
Managed: If you don't want this feature we will manage your home page for you.
URL Suffix: *
Note: Do not include the www.winterbreakuk.com part.
Can only contain letters, numbers, underscore _ and dash -. Any other characters will be rejected. Cannot contain the word 'winterbreak'. 		This forms part of your group website address. For example if you put brumbasket in this box, your webpage will be at www.winterbreakuk.com/brumbasket
Note: This should identify your group, and not your university/college. Don't use your university/college name here, use something unique to your group as there may be multiple groups at your university/college.
Password: * Your password must be at least 6 characters long.
Confirm Password: *
Additional Information
Referral Code:
If an agent has referred you, please enter the referral code here so that they will receive commission on your sales. 		If you enter a referral code and you gain a minimum of 30 bookings, you will receive a further £20 commission.
How did you hear
about Winter Break 2010?:
Any other relevant information: 		 
Have you travelled
with Outgoing before?:		 No
Yes 		 
If so, did you organise
the trip yourself?:		 No
Yes 		 
If so, how many people
went on the trip?:		  
How many hours per week are you able to dedicate to selling the trips?:  
Promotional Material
Contact Name: *
 This is the information that will be included on any promotional material - posters, eflyers etc.
Contact Email: *
Contact Number: *

I have read and agree to the Terms and Conditions of becoming a Group Leader.