TAILSRewards Card App

TAILSRewards Card Member Application

To apply for a membership card, please complete all questions.
Type of Member*

New MemberRenewing Member
Name*

First NameLast Name
Address*

Mailing Address

Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail:
Would you like to receive our monthly e-newsletter, 'The TAILS Times'?

Yes, please!
Signature*
Signature date*

My Products

product

TAILSRewards Discount Card$25.00

Quantity
Item subtotal:$0.00

Enter coupon

Thank you! You will receive your TAILSRewards Discount Card

via mail to the address provided in 3-5 business days!
THANK YOU FOR YOUR SUPPORT!
Payment Methods

Choose from one of the PayPal options to make your payment.
Should be Empty: