Super8 Rewards Card Online Application Form

Super8 Rewards Card Online Application Form
Date (Store to fill out)
Branch (Store to fill out)
Name*

Last NameFirst NameMiddle Name
Birthdate*

MonthDayYear
Place of Birth*
Gender*

FemaleMale
Civil Status*

SingleMarriedWidowed
Address*

No. / Street / Barangay

Street Address Line 2

Municipality / City / ProvincePostal / Zip Code

Postal / Zip Code
Mobile Number:*
Landline:
E-mail:
Customer Type:*

Business Owner / ResellerNon-Business Owner / Endcon
Business Owner?*

BakeryDrug StoreGrocery / Sari-sari StoreHORECA (Hotel/Restaurant/Canteen)Service SectorOthersNot Applicable
Card Number Issued (Store to fill out)
Application Requirements:

1. Please fill-out, print and present this form to Super8 Grocery Warehouse Customer Service.
2. Sign Terms & Conditions to be provided by our store personnel.
3. Bring 1 valid ID with photocopy.
4. Pay P100.00 for membership fee.

Super8 Store Personnel:

1. Fill-out the following fields above: Date, Branch &Card Number Issued.

2. Ask Customer to sign Terms & Condition and attach to this form.
Should be Empty: