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*Phone Numbers	AH:
	BH:
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What destinations have you travelled to in the past couple of years?
Please list your top 5 destinations that you would most like to visit in the future

Would you like to receive cruise information?		YESNO

Would you like to receive our newsletter?		YESNO

Which destinations are you interested in attending a film night on?

Would you like more information on corporate travel?		YESNO

Preferred airlines

Frequent flyer membership numbers	Airline:
	Number:
	Airline:
	Number:
Preferred hotel and resort chain

Star rating		luxury comfortable budget

Are you an American Express card holder? If so, would you like to receive information on exclusive deals available to you?		YESNO

Any additional information

PLEASE FILL OUT AND RETURN YOUR APPLICATION BY RETURN EMAIL OR FAX BACK ON (03) 9645 3811

ALL FILLED OUT APPLICATION FORMS WILL BE PLACED IN THE DRAW TO WIN A DINNER FOR TWO AT THE BELGIAN BEER CAFE