* You must fill in these fields.
Secure Application Form
This is a secure web site, as indicated by the lock icon. All information you enter into this online application is encrypted before being sent across the Internet. While we are confident about our security levels, we are not responsible for any loss or damages you may incur if a third party obtains access to your confidential information transmitted over the Internet. All your personal and account details are held in the secure area of our site. For more information please read our Privacy Statement.
Please note that you will need to consent to the Terms and Conditions and Privacy at the end of this application form. By completing this application online, you consent to the information and documentation being provided in electronic form.
Your email address must not exceed 150 characters.
Earn more Aeroplan Miles while sharing many of the benefits of Card membership with others. Please complete the details below for each person you intend to receive the Card. To add more Supplementary Cards to your account, please call 1-866-374-AMEX. Supplementary Card(s): No annual fee for up to 2 Supplementary Cards. Annual fee for additional Supplementary Cards is $50.00 each.
You may edit this text, but it cannot exceed 20 characters and it must include the Supplementary Applicant's last name.
Your Street # must not exceed 6 characters including spaces.Your Street Name must not exceed 20 characters including spaces. (Your Street # and Street Name combined must not exceed 20 characters)
Enter your Postal Code with no spaces (e.g. X0X0X0).
®*: Aeroplan and AeroplanPlus are Registered Trademarks of Aeroplan Canada Inc.
Copyright © 2014 American Express Company