Air Moldova :: Application form for corporate members

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Application form for corporate members

Application form for corporate members

All fields are required. In case of no data insert a through-line please. Write down your surname, name and additional name the same way as it is written in your international passport. Air Moldova will not disclose to third parties any personal information from the application form.

Corporation

COMPANY NAME:

BUSINESS TYPE:

CORPORATION ADDRESS:

E-MAIL:

PHONE NUMBER:

FAX:

Responsible person for correct use of the accumulated Credit Miles

NAME:

SURNAME:

ADDITIONAL NAME:

PHONE NUMBER:

PLEASE NOTE THE LANGUAGE YOU WOULD LIKE TO RECEIVE INFORMATION ABOUT ACCOUNT: Româna English Русский

QUANTITY OF MEMBERS:

List of staff members

Member #1

NAME:

SURNAME:

ADDITIONAL NAME:

PASSPORT NUMBER:

DATE OF BIRTH:

I AGREE TO ABIDE BY THE AIR MOLDOVA CLUB TERMS AND CONDITIONS

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