Loading

Application Form

Salutation:
If Others please specify:
First Name*:
Last Name*:
NRIC/Passort*:
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

captcha