Customer Sign Up Sheet

Customer Sign Up Sheet

Join Old Western Paint's Loyalty Program!
If you already signed up for the rewards program previously, please just fill out your name, email, and phone number. This renews your program eligibility and will ensure you receive the new sign up reward! (Spoiler alert, it's a super awesome hat!)
Full Name*

First NameLast Name
Company Name
If you currently have an account with us, please use same company name.
Email*
By providing your email, you are accepting terms that Old Western Paint will send you updates on your rewards status.
Phone Number*
We will not contact you via phone number unless we have questions regarding the information in your sign up sheet.
By completing this sign up form, you are agreeing to the following program rules:
- This is a Tiered Loyalty Program, rewards will be earned based on each level of dollar amount spent on your customer account.
- Your rewards will be accumulated and valid for a year starting the date this form has been completed.
- Any previous purchases from before date of sign up will not be recognized towards rewards.
- To qualify, all customers' accounts must be current within agreed upon payment terms.
- Rewards cannot be exchanged for cash.
- You will receive a one-of-a-kind custom designed hat for signing up!
Please know we will never sell your information or use it for any other purpose other than to create and keep track of your status on the Loyalty Program. If you have any questions regarding this program, your information, or where your status is currently at, please contact us at admin@oldwesternpaint.com or call 303-825-5147.
Signature*

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