|
*
Required Information |
|
Title |
|
Mr
Ms
Mrs Dr
Engr
Other
|
|
|
|
|
*Name |
|
|
|
|
|
|
*Date of
Birth |
|
Month
Day
Year (yyyy) |
|
|
|
|
*Gender |
|
Male |
Female |
|
|
|
|
*Marital Status |
|
Single |
Married |
|
|
|
|
*Home
Address |
|
|
|
|
|
|
*Town |
|
|
|
|
|
|
*State |
|
|
|
|
|
|
Postcode |
|
|
|
|
|
|
Telephone (home) |
|
|
|
|
|
|
*E-mail (home) |
|
|
|
|
|
|
Fax no (home) |
|
|
|
|
|
|
Hobbies |
|
|
|
|
|
|
Favourite
Colour |
|
|
|
|
|
|
Preferred
Newspaper/Magazine |
|
|
|
|
|
|
BUSINESS DETAILS |
|
|
|
|
|
|
*Job Title |
|
|
|
|
|
|
*Company
Name |
|
|
|
|
|
|
*Company
Address |
|
|
|
|
|
|
*Company Town |
|
|
|
|
|
|
*Company State |
|
|
|
|
|
|
Postcode |
|
|
|
|
|
|
Telephone (office) |
|
|
|
|
|
|
*E-mail
(office) |
|
|
|
|
|
|
Fax no (office) |
|
|
| |
|
* (Please indicate preferred
mailing address) |
| |
|
Home
Business
|
|
|
|
|
*Membership
type |
|
Personal Membership
Household Membership |
| |
|
|
|
Your User
ID must not be less than 6 characters. |
|
*User ID |
|
|
|
|
|
|
Password |
|
Password:
|
|
|
|
|
Verify
Password: |
|
|
|
|
|
Password Question and Answer |
If you forget your
Password,
you will be asked your date of birth, your user ID and the
Password Answer to your Password Question, to verify your identity before
allowing you to retrieve your Password. For your security and
convenience, make sure the Password Answer to your
Password
Question is:
- At least five characters in length
- Something only you will know
- Unlikely to change over time
E.g What is your favourite movie? |
|
|
|
|
*Password Question |
|
(Used only if you forget
your Password.) |
|
|
|
|
*Password Answer |
|
(Used only if you forget
your Password.) |
|
|
|
|
*
Declaration |
|
I wish to join the ADC Airlines Unicorn Club. I confirm
that i have read the conditions applicable to
membership. I also accept that membership privileges are
at the absolute discretion of ADC Airlines
and that ADC Airlines reserves the right at anytime and
without
notice to to modify, withdraw or decline my membership. |
| |
|
|
| |
|
|
