ACTA Request Form for AD75

Prior to requesting an AD75 discount

Please refer to the “Shopping Promotion codes” section of the “AD75 Program” to determine the applicable fare for your desired itinerary.

Travel Agency Name

Your Name

Verification ID number indicated on your ACTA membership card

IATA/TIDS #

Date of Request

Which class of service are you requesting:

Economy Business Premium Economy

If you are traveling with your spouse, please provide name

Travel Dates

Requests will be processed within 7 business days; your promotion code(s) will be emailed to you.

You may request a maximum of two AD75/AD50 per year.

Bookings must be made at aircanada.com/agents.

Please refer to Agent Reference at aircanada.com/agents for terms and conditions.

Please email this form with a valid copy of your ACTA Membership Card to ad75@acta.ca.