Member Profile Form

Name

Surname

Date of birth

E-mail address

Company

1. How often do you usually travel within a month?
<1 time1-3 timesMore than 3 times

2. The primary reason I travel is (Select one):
BusinessLeisure

3. Please advise any special requirements such as room type, bedding etc.

4. What are you favorite brands for travel and leisure? You can list up to 10 brands (i.e. Hakkasan; Emirates, Marriott etc)

5. Sitting Preferences
First ClassBusiness ClassCoachAisleWindow

Passport Details

6. Passport number

7. Issue Date

8. Expiry Date

9. Please check the focused hobbies/interests that best describe you (check box):
4-Wheel Drive ExpeditionAll-InclusiveBallooningClimbingCulinaryCyclingDivingEcotourismEquestrianEscorted ToursExtreme SportsFaith-Based TravelFamily AdventuresFishingGamingGardensGroup TravelHealth/FitnessHikingHistoryBoutique HotelsHuntingIndependent TravelerIndigenous CulturesMusicNaturalistOenology (Wine)Private JetRafting/KayakingRail TravelRanches/LodgesResortsSafariSailingSnow SportsSPASporting EventsTennisTheater/ArtTrekkingWater SportsWildlife

10. Choose your program (Account type) where you want your miles to be credited
Aeroplan & AltitudeClub PremierAAdvantageSkyMilesMileagePlusMiles & MoreFlying BlueExecutive ClubMilleMigliaFlying ClubPrivilege ClubMiles & SmilesSkywardsEastern MilesJetPrivilegeAsia MilesBIGQantas Frequent Flyer
11. Account number (To receive proper credit, the name provided above must match the name on he frequent flyer account.)


* I hereby consent to my personal data being processed so that it can be used to create a profile of my consumer choices so that I receive sales communications and offers tailored to my requirements. Personal Travel Business takes reasonable steps to protect any personal information it holds from misuse, loss, unauthorized access, modification or disclosure. We do not provide or sell, in whole or part, the personal information we collect and do not disclose it to third parties.