WESTERN UNION GOLD CARD APPLICATION
6
+
SEND
FAX
US YOUR COMPLETED
US YOUR COMPLETED
ENROLMENT FORM
ENROLMENT FORM
1. DOWNLOAD the enrolment form
1. DOWNLOAD the enrolment form
2. TYPE in the spaces provided
2. TYPE in the spaces provided
3. PRINT off the completed form
3. PRINT off the completed form
4. SEND the completed form to: Western Union Financial Services
4. FAX the completed form to: 00 612 9226 9111
(NZ) Pty Ltd, PO Box 91919, Auckland Mail Centre, Auckland 1142
To ensure you maximise the benefi ts of the Western Union Gold Card, simply complete all the details outlined on this application form. When you
receive your Western Union Gold Card, you’ll be able to use your card to access the details of the recipients you have entered onto this form.
So we can keep you informed of special offers and promotions available to you as a Western Union Gold Cardholder, please ensure you provide us with your
mobile number or email address when completing the application form. When you receive your Western Union Gold Card
, you'll be able to use your card to
SM
access the details of the recipients you have entered onto this form. For more information, simply call 0800 449 769, or visit
Your Information
Please use CAPITAL LETTERS and ENGLISH CHARACTERS when filling out the form. The form is already postage paid, so all you need to do is
complete your details and post it to Western Union. MANDATORY FIELDS are identified with an asterisk (*).
*Salutation
Mr
Mrs
Miss
Ms
*First/Middle
Name(s)
*Last Name
*Address
*Suburb
*City
* Postcode
(
)
*Home Tel No.
Mobile Phone No.
Email Address
Language
Preference
Receiver’s Information (the person you send money to)
Salutation
Mr
Mrs
Miss
M s
First/Middle
Name(s)
Last Name
Address
Country
Tel No.
Call 0800 449 769 to load additional receivers.
Open to persons 18 years of age and older with a valid New Zealand address. Western Union may use your personal data from this form to provide you with further
information about the services of Western Union and the services of other trusted third parties. If you do not wish to receive such information, please call
0800 449 769. Terms and Conditions will be sent with your Western Union Gold Card.
*Signature
Date