 |
|
|
|
|
ENROLMENT FORM
Please enter your invitation code if you have any.
|
|
|
Membership Tier |
|
To facilitate input, please complete this form in English. (*) indicates required information.
|
*Which hotel are you likely to stay?
|
|
*Title |
|
|
*First Name |
|
Middle Name |
|
*Last Name |
|
Gender |
|
Preferred Language |
|
|
|
Job Title |
|
Company Name |
|
*Address |
|
|
|
|
|
|
|
*City |
|
State |
|
*Postal Code |
|
*Location |
|
Contact Phone no. |
|
*Email Address |
|
|
|
Birthday (DD/MM/YYYY) |
/
/
|
Frequent Flyer Programmes
Please indicate your preferred frequent flyer programme (limited to partners of Langham Hotels International) for collection of miles when staying at qualifying rates at our hotels.
|
Name of Airline |
|
Frequent Flyer Programme Membership No. |
|
First Name (Shown on the membership card) |
|
Last Name (Shown on the membership card) |
|
Room Reference
|
ROOM
|
Room - Location
|
|
Room - Set Up
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| | |