* Required
APPLICATION FOR DINERS CLUB LODGED CARD
The Person who completes the application certifies that he is an authorized person to apply for the service on behalf of the firm.
Name of Business or Company Name
*
Address
*
P O Box
*
City
*
Telephone
*
Fax
Email Address
Please provide us an Email Address provided by QTel
Business Constitution (Type)
CR Number
Total Number of Employees
*
Approximate Annual Expense on Air Fares
Describe your company's policy on buying air travel tickets
Tickets purchased for executive business trips only
Tickets purchased for all employees
Other (Please Specify)
Preferred Travel Agents
,
Does any of your executives hold Diners Club Corporate Cards ?
Yes
No
Authorized Signer's Name
*
Title
*
ID Number
*
