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					                                                                                                                  Diners Club Card Benefits & Privileges:
                                                                                                                  • Up to 58 days interest-free credit
                                                                                                                    From the time of your charge until you settle your account.
                                                                                           DINERS CLUB
                                                                                                                  • Emergency cash advance locally and abroad
                                                                                                                    Available worldwide at selected ATMs and designated locations -
                                                                                                                    Diners Club offices, Citibank branches, participating hotels, etc.

                                                                                                                  • Emergency card replacement by next working day
                                                                                                                    Issued by the nearest Diners Club office, a service local bank-
                                                                                                                    issued credit cards cannot match.
                                                                                        C edit Card
                                                                                        Ar FFINITY
                                                                                                                  • Personal accident insurance
                                                                                         a p p l i c a t i o n      Expense-linked coverage (years of membership multiplied by past
                                                                                                                    12 months' spendings) of up to S$1,000,000 per life.

                                                                                                                  • Flight & travel inconvenience insurance
                                                                                                                    Flight accident cover of $250,000, and reimbursement for
                                                                                                                    essential purchase for lost baggage, missing of connecting
                                                                                                                    flight etc., when you charge your air-tickets to your Card.

                                                                                                                  • New purchase protection insurance
                                                                                                                    Extra protection against loss or damage for items above $200
                                                                                                                    charged to your Card.
                                                                                                     ®




                                                 PERMIT NO. 00429




           SINGAPORE 912301
                                                                                                                  • More than 90 “Members~Only” airport &




          ORCHARD P.O. BOX 15

         REPUBLIC OF SINGAPORE
                                                                                                                    business lounges worldwide




                                             BUSINESS REPLY SERVICE
                                                                                                                    Free entrance & complimentary refreshments for Cardmembers.

                                                                                                                  • Diners Club Rewards programme
                                                                                                                    Earn points every time you charge to your Card, and exchange




DINERS CLUB (SINGAPORE) PTE LTD 197300502W
                                                                                                                    your points for an array of free gifts including restaurant dining
                                                                                                                    vouchers, name brand items and even free air tickets.

                                                                                                                  • 0% interest-free instalment for road tax payment
                                                                                                                    Pay you vehicle road tax with 3 or 6 months instalments.

                                                                                                                  • 0% interest-free instalment plan
                                                                                                                    Buy-Now-Pay-Later - our flexi-payment for travel, furnishing,
                                                                                                                    electrical and other purchases. Enjoy up to 12 months interest-
                                                                                                                    free instalments at selected merchants.
                                                                                           FREE UNTIL YEAR 2008
                                                                                                                  *Terms & conditions apply

                                                                                                                  For current promotion, please call: 6416 0860




                                                                          paid by

                                                                         posting in
                                                                       licensee. For
                                                                      Postage will be




                                                                      Singapore only.
                                                 DINERS CLUB                            AFFINITY Credit Card                                                                application form
                                                                                                                                                                                                  Valid till 31 December 2008

YES! I wish to apply for the Diners Club Affinity International Credit Card
Entrance Fee:             $80 - WAIVED
Annual Fee:               $30 for Basic Card - WAIVED                                                           FREE UNTIL YEAR 2008
                          $15 for Supplementary Card - WAIVED


                                   PLEASE ATTACH YOUR RECENT PAYSLIP AND TAX ASSESSMENT TO YOUR APPLICATION
                                                (MINIMUM INCOME OF $30,000 PER ANNUM REQUIRED)
               ORGANISATION
      AFFINITY ORGANISATION                            THE INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS, INC. (IEEE)
      MEMBERSHIP NO.
                                                                                                                                                                                                                      AF39
                       PARTICULARS
           MY PERSONAL PARTICULARS                                                                                       SUPPLEMENTAR Y CARD
                                                                                                                                   ARY
                                                                                                                         SUPPLEMENTAR
FULL NAME AS IN IC/PASSPORT (PLEASE UNDERLINE SURNAME)                                                                              I WOULD LIKE A SUPPLEMENTARY CARD FOR MY SPOUSE OR
                                                                                                                      YES!           OTHER FAMILY MEMBER ABOVE 21 YEARS OF AGE
                                                                                                          FULL NAME AS IN IC/PASSPORT (PLEASE UNDERLINE SURNAME)                               RELATIONSHIP
DATE OF BIRTH              AGE               IC/PASSPORT NO.                NATIONALITY


                                                                                                          ADDRESS (IF DIFFERENT FROM BASIC CARD APPLICANT)
MARITAL STATUS            SEX                NO. OF DEPENDANTS              ACADEMIC QUALIFICATIONS


                                                                                                          TEL                            DATE OF BIRTH                         SEX             IC/PASSPORT NO.
LOCAL HOME ADDRESS


                                                                                                          NATIONALITY                    NAME OF EMPLOYER
                                                                          SINGAPORE (                 )
HOME TEL             H/P / PAGER                  YEARS              !OWN !MORTGAGED
                                                  THERE
                                                                     !RENTED !PARENTS'/RELATIVES'         POSITION HELD                                     TEL                                GROSS ANNUAL INCOME
                                                                                                                                                                                               S$
PERMANENT HOME ADDRESS

                                                                                                           PLEASE EMBOSS MY SUPPLEMENTARY CARDHOLDER'S NAME AS FOLLOWS:
                                                                                                           (MAXIMUM 23 SPACES, TO INCLUDE INITIALS OF FULL NAME AS WELL).
E-MAIL




           MY WORK                                                                                        OPTIONAL CreditShield                              – Outstanding Balance Credit Protection
                                                                                                          Your outstanding balance on your Diners Club bills will be settled upon premature death or total & permanent
NAME OF EMPLOYER
                                                                                                          disability from all causes. Any excess will be paid to your estate/ beneficiary.
                                                                                                          ! YES! I WISH TO ENROL IN CREDITLIFE. Please SIGN here to apply:_______________________
                                                                                                          I declare that I am under 60 years of age and that I have not been hospitalised in the last 12 months and suffer
ADDRESS
                                                                                                          from no physical defects, injuries or impairments, and that I am in good health. I agree to be bound by the terms
                                                                                                          and conditions of the policy to be issued. ($6 per month for coverage of $10,000 for aged 54 and below).
                                                                          SINGAPORE (                 )   Pursuant to section 25(5) of the Insurance Act (Cap 142), you are to disclose, fully and faithfully, all the facts
TEL                                                                 DATE JOINED                           as you know them or ought to know them. Failure to do so may render the policy issued void.

                                          EXT.
POSITION / DEPARTMENT                                           GROSS ANNUAL INCOME (MIN. S$30,000)
                                                                                                                         DECLARATION
                                                                                                                         DECLARATION
                                                                S$                                        By signing below,
                                                                                                          1. I/We request Diners Club (Singapore) Pte Ltd (DCS) to open a Credit Card Account for me/us and to issue
                                                                                                             Credit Card(s). It is understood that for joint applicants, the Credit shall be opened in the name of the first
                                                                                                             signatory who/which shall be the Basic Applicant.
              FAMILY
           MY FAMILY                                                                                      2. I/We warrant the truth and accuracy of the above information and all documents enclosed in support of this
                                                                                                             applicant.
SPOUSE'S FULL NAME AS IN IC/PASSPORT (PLEASE UNDERLINE SURNAME)                                           3. I/We authorise you to verify and exchange information on me/us between DCS and any third parties as DCS
                                                                                                             may deem appropriate.
                                                                                                          4. I/We agree to be bound by the Terms and Conditions of Issuance of Credit Cards(s) upon receipt or acceptance
                                                                                                             of or signing on or use to the Credit Card(s) unless you have received my/our return of the Credit Card(s), cut
DATE OF BIRTH              IC/PASSPORT NO.                          TEL
                                                                                                             into halves, to you. I/We know that such Terms and Conditions can be inspected at your office and a copy
                                                                                                             of it will be enclosed with the Credit Card(s) when issued.
                                                                                                          5. I/We agree that the Credit Card(s) may be sent to me/us at my/our risk by ordinary mail to my/our billing
                                                                                                             address.
           MY CREDIT REFERENCE                                                                            6. I/We confirm that at the time of this application, I am/we are not undischarged bankrupt(s) and no Statutory
                                                                                                             Demand nor any legal action process has been served on me/us.
I HOLD THE FOLLOWING CREDIT/CHARGE CARDS:                                                                 7. I understand that should my membership with affinity organisation cease, I must return the Card to Diners Club
1.                                                        A/C NO.
                                                                                                             (Singapore) Pte Ltd.

2.                                                        A/C NO.

!     I HAVE NEVER HELD A DINERS CLUB CARD BEFORE
                                                                                                          ________________________________________                       ________________________________________
!     I HAVE HELD A DINERS CLUB CARD BEFORE - A/C NO.:________________________________________            Signature of Basic Card Applicant / Date                       Signature of Supplementary Card Applicant / Date
PLEASE SEND MY BILLING STATEMENT TO:
                                                                                                                          FOR          DINERS                  CLUB              USE           ONLY
!     MY HOME         !   MY OFFICE           !   OR ___________________________________________           CR                           CH                          TC                            APP
PLEASE EMBOSS MY NAME ON MY CARD AS FOLLOWS:
(MAXIMUM 23 SPACES, TO INCLUDE INITIALS OF FULL NAME AS WELL).                                             ST                          DATE                                                      DATE


                                                                                                          DINERS CLUB RESERVES THE RIGHT TO CREDIT CHECK AN APPLICANT WITHOUT REFERENCE,
                                                                                                          AND TO REJECT AN APPLICATION WITHOUT ASSIGNING ANY REASONS THEREFOR.


                                PLEASE CALL                                 64160980                            FOR MORE INFORMATION

				
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