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ΑPPLICATION FORM FOR MILES & MORE VISA CREDIT CARD

 

DATE:

      20/11/2019

FIELDS MARKED WITH (*) ARE MANDATORY

EXISTING CUSTOMER OF ASTROBANK*:

 

 REQUESTED CARD LIMIT*:

 

1. MILES & MORE PROGRAM MEMBERSHIP INFORMATION

 YES, I AM A MEMBER OF THE MILES & MORE PROGRAM. MY MILES & MORE SERVICE CARD NUMBER IS (15 DIGITS):*  
Please enter your existing Miles & More service card number to ensure you earn miles on every purchase. Failure to do so will result in a duplicate automatic enrolment.
 NO, I AM NOT A MEMBER OF THE MILES & MORE PROGRAM. PLEASE ENROLL ME.

If you are not a Miles & More member or do not provide your Miles & More service card number, after signing the application, your personal information will be sent to Deutsche Lufthansa AG (Von Gablenz Str. 2-6, 50679 Koln) and a Miles & More service card will be issued in your name subject to the Miles & More terms and conditions which are available at www.miles-and-more.com.

2. PERSONAL DETAILS

SURNAME*:

NAME*:

FATHER’S FULL NAME:

DATE OF BIRTH*:

CITIZENSHIP*:

GENDER*:

EDUCATION*:

ID / PASSPORT NUMBER*:

DATE OF ISSUE*:

MARITAL STATUS*:

 

NO. OF CHILDREN*:

NAME AS IT WILL APPEAR ON THE CARD*:
(in Latin and Capital Letters)

3. CONTACT DETAILS

STREET*:

NUMBER*:

POSTAL CODE*:

AREA*:

TOWN*:

RESIDENCE*:

 

YEARS AT CURRENT RESIDENCE*:

E-MAIL:

HOME TEL. NUMBER*:

MOBILE NUMBER*:

FAX NUMBER:

MAIL ADDRESS:
(if different from above)

TOWN:

4. WORK DETAILS

OCCUPATION*:

EMPLOYER NAME*:

YEARS AT CURRENT EMPLOYMENT*:

TEL. NUMBER*:

E-MAIL:

STREET*:

NUMBER*:

POSTAL CODE*:

AREA*:

TOWN*:

5. FINANCIAL DETAILS (WHERE NOT APPLICABLE PLEASE INSERT 0) 

ANNUAL INCOME

AMOUNT €

ANNUAL EXPENSES

AMOUNT €

EMPLOYMENT INCOME*

LOAN INSTALMENTS*

OTHER INCOME*(rent / dividends / interest, etc): CREDIT CARD INSTALMENTS*
HOUSE RENT*
OTHER OBLIGATIONS*(insurance / taxes, etc)

TOTAL*:

TOTAL*:

6. ASSETS / LIABILITIES

ASSETS 

VALUE €

LIABILITIES 

VALUE €

DEPOSITS HOUSING LOAN BALANCES

CAR(S)

OTHER LOAN BALANCES

IMMOVABLE PROPERTY

OVERDRAFT BALANCES
SHARES / TITLE VALUE CREDIT CARD BALANCES
OTHER ASSETS

OTHER OBLIGATIONS

TOTAL:

TOTAL:

7. RELATIONSHIP WITH OTHER BANKS

1. BANK NAME:

    RELATIONSHIP:

2. BANK NAME:

    RELATIONSHIP:

8. REPAYMENT METHOD

DIRECT DEBIT*:

AMOUNT:

9. BRANCH

MY PREFERRED BRANCH IS:


DECLARATION

I declare that I agree and consent to the keeping in register/s, electronic and/or other, of all the data that concerns me and which the Bank receives through this application. In addition, I agree to the processing by the Bank of the data that concerns me in a manner consistent with the Data Protection Law (Protection of the Individual) 2001 as amended.

I have also been informed of the right of access and correction of my personal data upon submission of an application to the Compliance Unit of AstroBank and payment of a relevant fee. I am aware of my right to appeal to the Commissioner for the Protection of Data should my request for information not be answered, in a satisfactory manner, within 4 weeks.

I agree that AstroBank and Miles & More may share my name and contact information, as well as information necessary to administer the Miles & More program in conjunction with the Miles & More Visa credit card. I understand that the benefits of the Miles & More program - specifically the collection and redemption of award miles - are subject to the Miles & More terms and conditions which are available at www.miles-and-more.com.

SECURITY CODE*: