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Thank You Card Rewards APPLICATION

PLEASE COMPLETE AND SIGN THIS APPLICATION TO JOIN THE BASHAS’ THANK YOU CARD REWARDS PROGRAM. PRINT CLEARLY IN BLACK OR BLUE INK.

NEW CARD

REPLACEMENT CARD

NAME/ADDRESS/PHONE UPDATE

INTERNAL USE: PLACE STICKER HERE

STORE USE ONLY

STORE #

VERIFIED BY:

CURRENT CARD NUMBER

To update your Thank You Card application, call 1-800-759-4625 or www. bashas.com

THANK YOU REWARD #1

RECEIVE DISCOUNTS ON THOUSANDS OF ITEMS EACH WEEK; DISCOUNTS TO ARIZONA ATTRACTIONS, RECIPES FEATURING WEEKLY AD ITEMS, CHARITY GIVING, OPPORTUNITIES TO SAVE FOR COLLEGE

FIRST NAME ADDRESS CITY

LAST NAME

ADDRESS #2

STATE

ZIP CODE

-

M.I.

1. FIRST NAME

LAST NAME

DATE OF BIRTH

GENDER

2. FIRST NAME

LAST NAME

DATE OF BIRTH

GENDER

3. FIRST NAME

LAST NAME

DATE OF BIRTH

GENDER

4. FIRST NAME

LAST NAME

DATE OF BIRTH

GENDER

I understand that when I present my Thank You Card Bashas’ will keep a record of the products I purchase for its own internal use. I also understand that Bashas’ may mail special offers to my address which may contain coupons, offers or samples.

Signature

Check this box if you do not wish to receive promotional programs available to those whose personalized customer information is retained by Bashas’.

Check this box if you do not wish to receive E-Mail promotional programs available to those whose personalized customer information is retained by Bashas’.

Our Pledge To You: Bashas’ is dedicated to great customer service. In consideration of your privacy, we do not release or sell your name or address to another organization.

THANK YOU REWARD #2

PHONE NUMBER

IF YOU FORGET TO BRING YOUR THANK YOU CARD WITH YOU, WE CAN LINK YOUR PURCHASES TO YOUR THANK YOU CARD BY USING YOUR PHONE NUMBER

-

-

THANK YOU REWARD #4

CHILDREN INFORMATION

RECEIVE A FREE BIRTHDAY CARD WITH A COUPON FOR A CAKE ON YOUR CHILD(REN)’S BIRTHDAY (THRU AGE 10 ONLY)

THANK YOU REWARD #3

RECEIVE SPECIALS, NEWSLETTERS AND RECIPES VIA E-MAIL

E-MAIL

.

THANK YOU REWARD #5

HELP US GET TO KNOW YOU, RECEIVE SPECIAL OFFERS THAT ARE RELEVANT TO YOU

DATE OF BIRTH

GENDER

NUMBER OF PERSONS IN HOUSEHOLD

DO YOU HAVE INTEREST IN?

NUTRITION DIET/EXERCISE

IF YOU ARE A SEASONAL CUSTOMER CHECK HERE

SPRING

SUMMER WINTER FALL

COOKING WITH WHAT’S ON SALE TM

DO YOU OWN A PET? CAT

DOG

OTHER

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