Platinum Starwood Gold Preferred Guest Enrolment Form
To become a Starwood Gold Preferred Guest member, or to upgrade
to Gold status if you are already a Starwood Preferred Guest member,
please complete this enrolment form.
To become a Starwood Gold Preferred Guest member, or to upgrade
to Gold status if you are already a Starwood Preferred Guest member,
please complete this enrolment form.
This form must be completed by the Basic Platinum Business
Card member:
This form must be completed by the Platinum Business Supplementary
Card member:
Current Starwood Preferred Guest membership number
Current Starwood Preferred Guest membership number
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Title: Mr
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Mrs
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Ms
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Miss
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Dr
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(if applicable)
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Other
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Title: Mr
(specify)
Surname
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Mrs
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Ms
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Miss
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Dr
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Other
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(specify)
Surname
Given Name(s)
Middle Initial
Given Name(s)
Platinum Membership No.
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Middle Initial
Platinum Membership No.
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Expiry Date |
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Month
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Year
Date of Birth Mailing Address
Company Name
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(if applicable)
Home
Business
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Street Address
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Expiry Date Month
Date of Birth /
Mailing Address
Home
Company Name
(If using business)
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Year
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Business
Business
(If using business)
Street Address
City
State
City
State
Postcode
Country
Postcode
Country
Fax
Fax
Daytime Phone
Home
Business
Daytime Phone
Home
If you would like to receive your statements online and be informed of
special hotel offers, please provide your email address.
If you would like to receive your statements online and be informed of
special hotel offers, please provide your email address.
Email Address
Email Address
Awards Password
Awards Password
(Required for award redemption)
(Required for award redemption)
(Example: Mother’s Maiden Name)
(Example: Mother’s Maiden Name)
Please indicate your preferences.
Please indicate your preferences.
Room Preferences
Non-smoking
Floor Preferences Higher Floors
Bed Preference
Double/Double
Pillow Type Would you like to receive promotional
information via email from Starwood? Smoking Room Preferences
Non-smoking
Lower Floors
Floor Preferences Higher Floors
Lower Floors
King Queen
Bed Preference
Foam
Feather
Double/Double
Pillow Type Smoking King Queen
Foam
Feather
Yes
No
Would you like to receive promotional
information via email from Starwood? Yes
No Would you like to receive promotional
information via regular mail from Starwood? Yes
No
Would you like to receive promotional
information via regular mail from Starwood? Yes
No
No
Would you like to receive promotional
information from Starwood’s partners? No
Would you like to receive promotional
information from Starwood’s partners? Yes
By signing below, I acknowledge that I have read and agree
to the declaration and Terms and Conditions overleaf.
Signature of Card member
Yes
By signing below, I acknowledge that I have read and agree
to the declaration and Terms and Conditions overleaf.
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Date
Signature of Supplementary Card member
Please complete form and return via mail or fax to:
* Reply Paid 458, Platinum Service, American Express International, Inc. GPO Box 458, Sydney NSW 2001.
5 1800 246 481
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Date
Authority to American Express International, Inc.
under the Privacy Act:
To arrange for you to be enrolled as a Starwood Gold
Preferred Guest Member, American Express International,
Inc. needs to:
• collect personal information about you, and
•o
btain your agreement in relation to handling this
personal information
If you do not provide the information requested or give your
agreement opposite, American Express International, Inc.
may not be able to arrange for your enrolment as a
Starwood Preferred Guest Member.
I agree that, subject to the Privacy Act, American Express
International, Inc. may transfer my personal information
to Starwood.
Starwood Privacy Policy
Starwood collects information about you (both offline
and online) so that they can provide an experience that
is tailored to your preferences. Since your privacy is of
paramount importance to Starwood, they wish to protect
it and maintain your trust while collecting the information
necessary to do this. Starwood is fully committed to
providing information about the collection and use of
personal information furnished by, or collected from,
you while using their websites, products and services.
Starwood offer you the choice to decline (opt out)
participation in certain services and promotional benefits
provided by Starwood and/or its carefully selected third parties.
By using their websites, products or services, you
acknowledge and accept that you have read and agree to be
bound by Starwood’s Privacy Policy, which can be found at
http://www.starwood.com/preferredguest/privacy_policy.html
Starwood Gold Preferred Guest Program
Terms and Conditions
This offer is only valid until 31 December 2010 and available
to the Platinum Business Basic and Supplementary Card
member. Information provided herein is correct at time
of printing and is subject to changes without prior notice.
Membership of and all promotions associated with Starwood
Preferred Guest are subject to Terms and Conditions of the
Starwood Preferred Guest program (which can be found at
www.spg.com), and these are subject to change without
prior notice. Starwood Hotels & Resorts Worldwide, Inc.
and/or its affiliates shall not be responsible in any way for
any omissions or typographical errors.
American Express International, Inc. ABN 15 000 618 208.
Incorporated with Limited Liability in Delaware, USA. ® Registered Trademark of American Express Company.
AMXSBS0069_Starwood