New Member Registration


Company Information
Company Name:*
Tax Identification Number (INN):*
Industry:
Contact Person:*
Contact Person Position :*


Agency Code:
Agency Code:*

Member Information

Please note that the Registration Form must be completed accurately in accordance with your passport details. If passport data is changed you must inform Belavia Leader Customer Service immediately. Passport details must match the data on your Registration Form, otherwise it may result in late crediting of points to your personal account.

Last Name: _{latin letters, as in the passport}

First Name: _{latin letters, as in the passport}

Middle Name:

Date of Birth:

Gender:

Passport:

Passsport Type:

Country:

Passport Number:

Expiration Date:

How to Connect with You?

Country code

Cell Phone

Country code

Home Phone

Confirm Email

I do not agree to receive the news about the Program.

Language of correspondence and communication

I have read the airline's privacy policy and I hereby consent to the processing of my personal data at the loyalty program "Belavia Leader".

I agree to the Belavia leader loyalty program Terms and Conditions.

Type the code shown

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