AviaCard * Private

We would be happy to accept your application for a card.
To do this, please complete the form below.
The required fields are marked with *.

Details of the contract

Choose which AVIA member company you want to be supported by:

I am already a customer or would like to select the the supporting AVIA member company.

I would like the servicing AVIA member company has to be selected based on the local petrol station.

Choose your AVIA company:

A.H. Meyer & Cie AG
8003 Zürich

AVIA Distribution SA
1052 Le Mont-sur-Lausanne

Ernst Hürlimann AG
8820 Wädenswil

Fritz Meyer AG
4052 Basel

Küng AG Bern
3008 Bern

Lang Energie AG
8280 Kreuzlingen

Osterwalder St. Gallen AG
9000 St. Gallen

Osterwalder Zürich AG
8052 Zürich

Schätzle AG
6002 Luzern

Your local petrol station:

Salutation

Mrs.

Mr.

Other

Firstname

Lastname

Date of birth Format: [dd.mm.yyyy]

Profession

Nationality

Other

Address and contact details

Card details

Further information

Completion

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