Mileage Rewards Enrollment Form

You are required to enroll in HSBCs Mileage Rewards Program if you wish to transfer your Bonus Points to Asia Miles, Krisflyer or Mabuhay Miles. Please fax this form to (02) 755-5034 or mail to our Cards Products Center P.O. Box 1096 Makati Central Post Office, Makati City, Metro Manila. If you have already faxed your form, please do not mail the form again to avoid duplication. Please complete this form using capital letters and black ink. Mr./Mrs./Ms. FIRST NAME LAST NAME

HSBC Credit Card Number

Passport Number

Asia Miles Membership Number

KrisFlyer Membership Number

Mabuhay Miles Membership Number

I have read and agreed to be bound by the terms and conditions of the Mileage Rewards Program offered by HSBC and hereby agree and authorize HSBC to debit above credit card account annually for: P500 as payment for the annual mileage Program fee for Asia Miles Membership* P500 as payment for the annual mileage program fee for KrisFlyer Membership* P500 as payment for the annual mileage program fee for Mabuhay Miles Membership*

Signature of Cardholder

mm/dd/yy

*The fee will be debited from the above credit card account in the month following receipt of this. NOTE: If you posess more than one credit card from HSBC, only one account number is required. HSBCs Mileage and Rewards Program terms and conditions apply.