American Express @ Work®
Enrollment Form for Program Administrators and Reporting Recipients
- Each enrollee needs to complete a separate form -
REQUIREMENTS:
An Internet connection
A 4.x browser with 128-bit encryption is required to use American Express @ Work. To check a browser to
see if it has 128-bit encryption, please use the following steps:
In Internet Explorer:
1. Open Internet Explorer.
2. Click on the “Help” pull down menu
3. Click on “About Internet Explorer
4. If the resulting screen says that the cipher strength =
128 bit strength, then the browser will work with
American Express @ Work.
5. If the cipher strength = 40 bit strength, then the
browser will not work with American Express @
Work.
In Netscape Navigator:
1. Open Netscape Navigator or Netscape
Communicator.
2. Click on the “Help” pull down menu.
3. Click on “About Navigator” or “About
Communicator”.
4. If the bold writing at the bottom of the screen reads
“This version supports US Security,” then the
browser will work with American Express @ Work.
5. If the bold writing at the bottom of the screen reads
“This version supports International Security,” then
the browser will not work with American Express @
Work.
The Enrollment Process
1) Before this form is submitted, the Program Administrator’s or Reporting Recipient’s Corporate Card or
Corporate Purchasing Card hierarchy must be created.
2) Complete this form and send it to Corporate Services Operations by:
 Scanning a completed and signed form and emailing it to [email protected].
or
 Emailing a softcopy to your Authorizing Officer noting “I confirm my enrollment” and then having your
Authorizing officer forward over approval and the attached form to [email protected] noting “I
authorize this enrolment.”
or
 Faxing a signed form to (905) 940-7653 or toll-free 1-800-685-0534 (ensure the application is
positioned properly depending on your machine).
This form is set up to simply tab between areas requiring input. For check boxes click on the desired box to
insert “x”.
3) The CorpCDAPA Team will register you and send a confirmation through e-mail to you. Please make sure
the proper business e-mail address is captured on the form. Without this, you cannot be registered.
4) After receiving the confirmation email, you will be able to access the functionality of American Express @
Work which is relevant to you.
5) Important note: In order to gain access to American Express @ Work, you must remember the Verification
Word and Verification PIN completed on this form. The Verification Word and Verification PIN are only used
for the initial set-up process.
Corporate Services Operations Email address: [email protected]
Corporate Services Operations Phone Number: 1-866-568-0308
Corporate Services Operations Fax Number: (905) 940-7653 or toll-free 1-800-685-0534
Please email the completed form to [email protected]
American Express Corporate Services
American Express @ Work® – Enrollment Form
Please complete this form to enroll in American Express @ Work for access to Online Program Management (OPM) and Reporting.
When completed please e-mail [email protected] or fax this form to (905) 940-7653 (toll-free 1-800-685-0534).
Personal information requested on this Enrolment Form is collected and used only for the purposes of enrolling you in OPM and Online
Information Services (OIS) Reporting, and authenticating your identification when you log in.
Account Manager Information (to be filled in by American Express if applicable)
1
Name (Please tick box)
Mr.
Mrs.
Miss
Ms.
@aexp.com
Email
Telephone number
2
Enrollee’s Information (to be filled in by the Program Administrator/Reporting user requesting access to American
Express @ Work)
New User
Exiting User (Other Region)
Personal Information
Last Name
Title
Address
Province
Country
Business Fax
First Name
Company
City / Town
Postal Code
Business Tel. No.
Business Email Address
Authentication Information
Verification Word – You must remember this word as it is required for authentication when prompted
(at least 4 and no more than 20 alpha numeric characters)
Verification Pin (length must be 4 numeric characters)
**Existing User
(4 digits):
User ID is required
**Existing User other Region – No need to provide Verification word and Verification Pin, only provide User ID
Please note that PA Shared Access can be delegated only to PAs that are set up under the same Primary Market. If sharing is to be
done across multiple regions then a User ID will need to be created for each individual market that needs to be supported.
Select Services (to be completed by the enrollee)
3
Please select the services you would like access to:
Online Program Management
(if checked complete section 4 below)
Standard Reporting
(if checked complete section 5 below)
Statement Delivery Selection
Business Travel Account Online
Statement
(if checked complete section 6 below)
(if checked complete section 7 below)
Please email the completed form to [email protected]
4
Online Program Management
(to be completed by the enrollee if applicable)
Corporation name
Corporate ID (CID)#
(Example: 123456) (if
known)
Highest level Control
Account
Example: 3799-99999999999
6
Standard Reporting
(to be completed by American Express)
Recipient ID (required for Reporting
recipients)
Fiscal start Month
1.
-
-
2.
-
-
3.
-
-
Statement Delivery Option
(to be completed by American Express and the
enrollee)
Statement Delivery Option: Paper Off
Cardmember
Convenience (default )
If Paper off is chosen, please indicate CID and BCA(s)
Corporation name
Corporate ID (CID)#
(Example: 799999)
Basic Control Account
1.
Example: 3799-999999-99999
2.
3.
4.
Basic Control Account #1
Basic Control Account #2
3733373337333733-
7
5
Basic Control Account #3
Basic Control Account #4
37333733-
37333733-
Basic Control Account #3
Basic Control Account #4
3733-
3733-
Business Travel Account Online
Statement
Corporation name
Corporate ID (CID)#
(Example: 799999)
Basic Control Account
Example: 3799-999999-99999
Basic Control Account #1
3733-
1.
2.
3.
4.
Basic Control Account #2
3733-
BTA
Number
(last 7
digits
only)
Please email the completed form to [email protected]
If you have additional CID (s), BCA(s) or BTA (s) Account Number(s), for any of the above sections, please append
this information on an additional page and ensure included when this enrollment form is submitted.
7
Confirmation/Authorization of Enrollment
(To be completed by enrollee and an authorizing individual within the enrollee’s organization)
Enrollee
First Name:
Date:
*Signature of Enrollee:
Last Name:
Authorizing Officer
Date:
First Name:
Last Name:
Title:
*Signature of Authorizer:
*You can email Confirmation/Authorization of Enrollment to American Express in lieu of handwritten signatures by sending an email to
your Authorizing Officer noting “I confirm my enrollment” and then having your Authorizing Officer forward your email and the attached
form to [email protected] noting “I authorize this enrollment”. Faxed forms require handwritten signatures.
Please email the completed form to [email protected]