JAL USA CARD Rewards Change Request Form
Basic to Premium ($50 Premium Rewards Upgrade fee will be charged)
Premium to Basic
      (Please note that the $50 Premium Rewards Upgrade fee will not be reimbursed)
* JMB お得意様番号 :
* Primary card holder's JMB Number:
* 本会員の名 :
* Primary card holder's First Name:
Please enter as it appears on your credit card.
* 本会員の姓 :
* Primary card holder's Last Name:
* 誕生日 :
* Primary card holder's Date of Birth:
* メールアドレス :
* Email Address:
Credit terms に同意します。
I agree with terms and conditions.