Discovery Co-op Referral Reward Claim

Discovery Co-op Referral Reward Claim
Who's completing this form?
- Full Name
- Co-op Number
- Phone Number Used for Sign-up
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Date Joined
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Did you join online or in-store?
- Referrer Full Name
- Referrer Co-op Number
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Relationship to the new member
- Switcher Acknowledgment
- We used to share a family Co-op number, but now have our own.
- Verification and Consent
- I confirm that the information provided is accurate and understand that Discovery Co-op will verify membership details beore issuing rewards.
- Your information will only be used to verify your Discovery Co-op membership and referral eligibility. Discovery Co-op will never sell or share your personal details.
- Should be Empty: