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Please complete your application and submit it using the "Submit" button at the bottom of the page. Upon acceptance of application we will verify references and evaluate in if your application should be approved. Please List 3 Freight Forwarders as your references.

*Company Name:
Main Office Address:
City:
State:
*Country:
*Key Contact :
Position:
*Telephone:
*Fax:
After Hours Telephone Number:
*Email:
Website:
Additional Locations/Branch Offices:
(All offices must pay the annual dues in order to be listed as members of WAN.)
Year business was started :
Number of Employees:
   
Licenses/Certifications
Customs Broker
NVOCC
FMC (U.S. ONLY)
ISO Certifies
FIATA
IATA/CNS
   
Services
Customs Brokerage % of volumn
Import Ocean Forwarder %
Export Ocean Forwarder %
Import Ocean NVOCC %
Export Ocean NVOCC %
Import Air Forwarder %
Export Air Forwarder %
   
In which markets do you have existing agents you do not wish to change?
   
In which markets are you most interested in developing new partnerships?
   
Company Ownership
Please list the individuals, entities, or other ownership structure of your company.
Name: Percent Owned:
Name: Percent Owned:
Name: Percent Owned:
Capitalization (optional): (Specify Currency):
If Public: Stock Exchange:
Shares Outstanding:
Price:
Currency:
   
Affiliations
Please list any other private trade groups to which you belong:
   
Banking Information
Bank Name:
Address:
City:
State:
Country:
Phone:
Fax:
Account Number:
Routing:
   
Freight Forwarders References you must submit at least 3.
1. Company Name:
  Type of Business:
  Contact:
  Phone:
  Fax:
  Email:
     
2. Company Name:
  Type of Business:
  Contact:
  Phone:
  Fax:
  Email:
     
3. Company Name:
  Type of Business:
  Contact:
  Phone:
  Fax:
  Email:
   
Does your company maintain an E&O policy?
Underwriter:
For the purposes of compiling for publication the combined total turnover of the group, please inform us of your annual revenues from freight forwarding activities (optional):
Airfreight: US$
Ocean Freight: US$
Domestic Hauling: US$
Warehousing: US$
*Name of Applicant:
Date:
*Email:
*Human Check:
Please email additional information describing market or company strengths and any other details that will be helpful in knowing more about your operation.
 
Click the submit button above to submit the rate request, and you will receive a response from us soon.
* denotes mandatory field.