PASSENGER REGISTRATION FORM Section 1: Organization and Agreement Details To be filled out by Arik Air Name of Organization: Edo National Association Discount Code: EDO2010 Agreement Details: Arik Air will provide any applicant who is a member of the above stated organization with a discount of 20% on the lowest available published Economy Class fare from New York JFK to Lagos, Abuja and/or Benin Nigeria on the desired date of travel. Section 2: Passenger Details To be filled out by the passenger Last Name: First Name: Permanent Address/Street: City: ZIP Code: State: Country: Email: Telephone number: Date of Birth: (MMDDYY) Country of Citizenship: Passport number: Passport Expiration Date: Country of Issuance: Departure from (City): Date of Departure (Outbound): (MMDDYY) Travelling to (City): Connecting Flight to (City)*: One Way Round Trip Date of Departure (Return)**: (MMDDYY) Class of Service: Premier Class Economy Class *Please leave blank, if travelling on a direct flight. **Please leave blank, if travelling on a one way trip. Section 3: Terms & Conditions Arik Air will provide the EDO USA and Canadian based members traveling from New York, JFK to Lagos, Abuja and/or Benin, Nigeria with a 20% discount on their lowest available economy class published fare on the requested date of travel. Any expense needed to get to/from JFK International Airport for your flight will be the passenger’s responsibility. All tickets must be purchased by 30 October and travel must take place between 15 Novemberr 2010 and 15 January 2011. There will be no discount applied to taxes, fees and related charges. Discounts do not apply to cargo, excess baggage or any additional service requested or provided. I have read, understand, and agree to the terms and conditions of applying for an Arik Air group discount. Signature: ______________________ Date: ______________________ Please fill out this form electronically and fax it with your signature to Arik Air: 646-349-4606. We will contact you at the phone number indicated above to arrange payment.
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