Member Details

(to register for newsletters or update your mailing address)

  First Name:         Surname: 

  Mail Address:  Street / PO Box 

                      Town / Suburb:    Postcode:   

  Email address: 

  Card Number:     Expiry Date:  Month    Select one January February March April May June July August September October November December   Year  2014 2015 2016 2017 2018 2019 2020

  If you do not wish to complete the feedback section select send here:

Feedback

To help us bring you the best benefits possible, please give us a little more information about yourself.

  About you:

        Sex:  M   F       Age group  Select one Under 18 18 to 25 26 to 35 36 to 45 46 to 60 Over 60     Work: Select one Employed Not employed Pensioner Retired Student Other

  About your membership:

        Are you a Rewards Club member?  Select one No Yes - less than 1yr Yes - over 1 year Yes - over 2 years Yes - over 3 years

        How did you hear about the Rewards Club?  Select one Local Club Family Friend Newspaper Promotion Website Radio Retailer / Restaurant Work    

        How did you join the Rewards Club?      Select one Local Club Employee membership Internet order Phone Order Other   

  About the benefits:

        List your top 4 benefits categories: 

         Auto     Entertainment     Fitness & Health     Grocery     Hair & Beauty   

        Leisure  Home & Garden     Restaurants    Shopping     Sporting     Travel

         Other:

        What are your 3 favourite businesses?   

        What new businesses would you like us to approach?                           

        Have you tried a new Rewards Club business?   Select one No dont think I will Yes Not yet but plan to                          

        What is the best thing about the Rewards Club? 

        How can we improve our: website, suppliers, directory, value etc?          

        General comments:

Thank you for your time. Your information will not be passed to any third party for marketing purposes. Your information helps us improve the Rewards Club for our members. If you do not wish to receive updates please tick here