Premium Flight Club ABN 92 618 527 530

FLIGHT VOUCHERS BOOKING FORM

To submit your form: - Email your completed booking request form to info@premiumflightclub.com.au . This must be accompanied by photo ID. - First flight should be no sooner than 14 days after you submit the above. - Please allow a minimum of 48 hours for our team to process your booking and process payment on your preferred credit card. - One of our team members will be in touch with you once the booking has been processed and confirmed.

Membership Information MEMBER NAME:

PREMIUM FLIGHT CLUB MEMBERSHIP #:

MEMBER PHONE NUMBER:

MEMBER EMAIL ADDRESS:

MEMBER PHYSICAL ADDRESS:

MEMBER POSTAL ADDRESS:

FOR OFFICE USE ONLY

BOOKING #

PNR#

Passenger Information PASSENGER 1 NAME

(as per Passport / Photo ID):

NAME: SURNAME:

TITLE:

DATE OF BIRTH:

PASSPORT NUMBER:

PASSPORT EXPIRY:

ISSUING COUNTRY:

NATIONALITY:

FREQUENT FLYER DETAILS:

PASSENGER 2 NAME (as per Passport / Photo ID):

NAME: SURNAME:

TITLE:

DATE OF BIRTH:

PASSPORT NUMBER:

PASSPORT EXPIRY:

ISSUING COUNTRY:

NATIONALITY:

FREQUENT FLYER DETAILS:

PASSENGER 3 NAME (as per Passport / Photo ID):

NAME: SURNAME:

TITLE:

DATE OF BIRTH:

PASSPORT NUMBER:

PASSPORT EXPIRY:

ISSUING COUNTRY:

NATIONALITY:

FREQUENT FLYER DETAILS:

PASSENGER 4 NAME (as per Passport / Photo ID):

NAME: SURNAME:

TITLE:

DATE OF BIRTH:

PASSPORT NUMBER:

PASSPORT EXPIRY:

ISSUING COUNTRY:

NATIONALITY:

FREQUENT FLYER DETAILS:

Flight Information FARE CLASS: ECONOMY PREMIUM ECONOMY BUSINESS/ FIRST

FLIGHT REQUIRED: ONE WAY FLIGHT RETURN FLIGHTS MULTI STOPS

ROUTE E.G. SYD/MEL/SYD

DEPARTURE FLIGHT NUMBER: FULL FLIGHT NUMBER: CHOSEN DEPARTURE AIRLINE:

AIRPORT/CITY: DEPARTURE CITY: ARRIVAL CITY:

DEPARTURE DATE: DEPARTURE TIME:

RETURN FLIGHT NUMBER: FULL FLIGHT NUMBER: CHOSEN RETURN AIRLINE:

RETURN DATE: RETURN TIME:

SPECIAL SERVICE REQUEST:

LUGGAGE REQUIREMENTS (ADDITIONAL CHARGES MAY APPLY FOR CHECKED BAGS):

MEALS (ADDITIONAL CHARGES MAY APPLY FOR MEAL REQUESTS):

SEATING REQUEST (ADDITIONAL CHARGES MAY APPLY TO SELECT YOUR SEATS):

TOTAL COSTS OF FLIGHTS AND EXTRAS YOU FOUND INCLUDING TAXES (COSTS ARE BEFORE APPLYING

YOUR $200 FLIGHT VOUCHER):

COST TO BE CHARGED TO CREDIT CARD (AFTER $200 FLIGHT VOUCHER HAS BEEN APPLIED)

NOTE: EACH FLIGHT VOUCHER BOOKING WILL INCURE A CASH BOOKING FEE OF $29, THIS CHARGE WILL BE ADDED TO ANY ADDITIONAL FEES OUTSIDE OF THE

$200 FLIGHT VOUCHER.

Flight Voucher Terms and Conditions 1. Flight Vouchers can be used as full or partial payment on most domestic or international airlines (e.g. what you see on Webjet we can

book for you).

2. Premium Flight Club Members receive 3 X AUD $200.00 in Flight Vouchers.

3. Each Flight Voucher has separate validity and booking terms and periods:

a. Flight Voucher One can be applied for bookings and is valid for 12 months from the date of issuance (for avoidance of doubt

this is the recorded date the Flight Voucher has been issued to your on-line account).

b. Flight Voucher Two can be applied for bookings and is valid for 12 months to 24 months from the date of issuance and is only

valid if Flight Voucher One has been redeemed and Premium Flight Club Rewards Dollars Accommodation Vouchers have

been redeemed and replaced in the previous 12 months. If Flight Voucher One has not been redeemed, then Flight Voucher

Two and Three are cancelled and have no value.

c. Flight Voucher Three can be applied for bookings and is valid for 24 months to 36 months from the date of issuance and is

only valid if Flight Voucher One and Two have been redeemed and Premium Flight Club Rewards Dollars Accommodation

Vouchers have been redeemed and replaced in the previous 12 months. If Flight Voucher One or Two have not been

redeemed, then Flight Voucher Three is cancelled and has no value.

4. Flight Vouchers can only be applied to one booking and must be used in their entirety. No refunds or credits will be given to un used

portion of Flight Voucher e.g. if a AUD $200 Flight Voucher is used for a $185 flight then all of the Flight Voucher has been used.

5. Multiple flights or passengers can be applied to each Flight Voucher with the provision that one Flight Voucher only can be applied to

each booking provided that the owner of the Flight Voucher is included in the booking. Booking must be made at same time. E.g. For

return trip flights for 2 people total AUD $215 you can apply the voucher to the whole transaction and only have AUD $15 to pay.

6. Should you cancel or amend your flight booking then standard airline Terms and Conditions apply. Changes made through Premium

Flight Club – Flight Team will incur a AUD $50 administration charge.

7. No refunds will be applied to your Flight Voucher.

8. Flight Vouchers are not transferable.

9. Flight Vouchers cannot be redeemed for cash or other items.

10. Lost or misplaced Flight Vouchers cannot be reissued.

11. A non-refundable booking service fee in cash of AUD $29 applies to each flight voucher booking.

12. Flight Voucher Terms and Conditions can change at any time without notice.

13. Flight Voucher bookings are deemed acceptance of all Flight Voucher Terms and Conditions

14. Passport must have at least 6 month’s validity from date of departure

15. Flights are subject to availability and prices are subject to change

16. If any membership payment has been missed or dishonored, then flight vouchers cannot be used until membership is paid in full.

17. Please note you cannot combine Premium $200 Flight Vouchers with Additional Bundle Flight Voucher to use towards the same flight booking.

18. Flight Vouchers are issued by Premium Flight Club Pty Ltd ABN 92 618 527 530.

CHARGE/CREDIT CARD DEBIT AUTHORITY

EMAIL BACK TO: info@premiumflightclub.com.au

I …………………………………………… authorize Premium Flight Club Ptd Ltd or its’ Suppliers to debit my: (Name of cardholder as shown on card)

*Visa *MasterCard *American Express (please circle one) *Card Security Number

CARD NUMBER

EXPIRY DATE / IN THE AMOUNT OF A$ ….………….………..……..………..….

AMOUNT IN WORDS All transactions are calculated and processed in Australian Dollars (AUD) at the time of payment. No responsibility is accepted for credit card currency exchange rate fluctuations and fluctuations which may occur between transactions.

………………………………………………………………………………………………………………………………

CARDHOLDER’S BILLING ADDRESS

………………………………………………………………………………………………………………………………

AUTHORITY FOR SINGLE TRIP ONLY CONTINUING AUTHORITY TO REMAIN ON FILE

(Select your preferred arrangement)

FOR CONTINUING AUTHORISATION ONLY - THIS AUTHORITY IS VALID UNTIL THE CREDIT CARD DETAILED ABOVE EXPIRES OR IS REVOKED IN WRITING BY YOU

I acknowledge that Premium Flight Club Pty Ltd is not required to produce a copy of a signed validated Sales voucher to obtain payment.

I consent that Premium Flight Club Pty Ltd may rely on this authority to pass to suppliers with whom travel arrangements are being made and further understand charges may appear on my Credit Card statement in the name of the supplier providing the travel arrangements.

I acknowledge and agree to pay the non-refundable Credit card merchant fees that may apply to the transaction. These will vary between 1.98% and 3.3% of the amount charged depending on the type of card.

I acknowledge and agree the financial obligations of Premium Flight Club Pty Ltd have been completed upon payment of suppliers for travel arrangements and I undertake not to dispute this debit where made in favor of Premium Flight Club under these circumstances.

CARDHOLDER’S SIGNATURE ……………………………………………………….. DATE ……………..…...

PASSENGER NAME/S ……………………………………………………DEPARTURE DATE .……….….…….. (If other than Cardholder)

SUPPLIER/S ……………………………………………………………………..……………………………….………

Premium Flight Club Pty Ltd ABN 92 618 527 530

CONSULTANT USE ONLY

PHC is merchant Supplier is merchant CONSULTANT: ………..…………… TRIP #: ………….