Application Form

Salutation

If Others please specify

First name*:

Last name*:

NRIC/Passport*:

Nationality*:

Date of Birth*:

Gender:

Marital Status

If Others please specify


Name of Employer/Business*:

Self Employed?

Office Address*:

Country:

State:

City:

Postal Code*:

Tel:

Fax:

Mobile:

Email*:


By checking on the box below, I confirm that I have read and accepted the Explorer Club Rewards Membership Programme Terms and Conditions. I understand that written permission from my company have to be obtained and shall be produced upon request by the hotel for verification. I understand that Explorer Club Rewards may reject this application at its sole discretion.

I have read and agreed to abide by the Terms and Conditions of Rewards

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