The form for participation of organization in the program «Belavia Leader»

LETTERHEAD

Belavia Leader group

RUE «National Airline "Belavia"

The form for participation of organization in the program «Belavia Leader»

We ask to register as the member of the program «Belavia Leader» _______________________________________________________________

(the full name of the organization)

For registration the following data is provided:

The legal address of the organization:

________________________________________________________________

(country, city, street, house, case, office)

The postal address of the organization:

_________________________________________________________________

(country, index, city, street, house, case, office)

Responsible person of the company: ____________________________________

(surname, name, second name)

_______________________________________ _____________________

(position) (phone)

________________________________________

(e-mail address)

For employees of our organization, that have shown a corporate member’s card, we ask to establish following conditions of charging points for flights:

Organization' account ________ %

Personal account of the employee ________ %

(The total percent sum specified above should be equal 100 %. In case the sum is not equal to the specified size, the organization will not be registered.)

The responsible person we appointed, bears responsibility for safety of the confidential password for access on personal page of the company on the site www. . Not later than 3 days before changing the responsible person, we undertake to ask the airline for password change, and also to inform about the new responsible person data.

We confirm that we know the program rules and we agree with them. The list of employees of the organization (a surname/name in a Latin transcription, individual number of the «Belavia Leader» member) is applied.

The director ______________

(signature)

The list of employees of the organization _________________________________

(name)

№	Name of the employee (Latin letters, as in passport)	Surname of the employee (Latin letters, as in passport)	Individual number of the «Belavia Leader» member	Employee number of the «Belavia Leader» member (is filled by the airline)

The director ______________

(signature)