Date: ______Received by: ______

(For Amway use only)

To: The Committee

Amway Leadership Seminar 2015 Las Vegas

Travel Arrangement Special Request

Please indicate your option:

1 ADA Extension

1 Grouping / Travel Together

1 Own Deviation / Extension

We would like to extend our trip as below:

1)  Date of return: ______

2)  City of return : ______

1 Other Special Request (if any)

______

______

For the above request, below are the name list:

ABO Number / Passport Full Name / Town / Contact Number / Cheque Number for
ADA Extension (if any) / Signature

Main person to contact for this group is:

ABO Number / Passport Full Name / Town / Contact Number / Email Address / Signature

Note:

1.  All communication will be channel to the appointed main contact person only. After which, the main contact person will be required to disseminate the information to the remaining travelling partners in their group.

2.  Any special request may involve additional cost which will be borne by you. We do not guarantee availability of any extension or deviation or special request, but will try our best to accommodate. You will be duly informed of the outcome of your request.

Please return the complete form no later than 25 September 2015 to:

For Malaysia: For Singapore:

Bing Yi Brian Tey

Tel: 03-7946 2115, Fax: 03-7946 2199 Tel: 6550 9905, Fax: 6550 9940

Email: Email:

For any updates on your request, kindly contact the below after 25 September 2015:

Holiday Tours: 03-6286 6066