Magrudy's Loyalty Programme

Customer Details

Title:
First Name:
Last Name:
Supplementary Card Holder Name:
Birthday:
I confirm that I am under 14 years of age, and I have obtained parental consent.
Gender:	Male Female:
Marital Status:	Unspecified Single Married
Do you have any children ?	Yes No
Nationality:
Mobile Number	e.g 971501234567 - no spaces
Home Number	e.g 97141234567 - no spaces
Office Number	e.g 97141234567 - no spaces
Fax Number	e.g 97161234567 - no spaces
Email:
Job Title:
Job Description:
Company:

Mailing Address

Your Magrudy's Loyalty Card will be sent to this mailing address. This information is mandatory.

UAE Resident International

UAE Resident International

P.O Box:

e.g 1144 (digits only)

Address Line 1:

Address Line 2:

City:

Address Preview

Please make sure the below address is correct

              ____________________________

              ____________________________

            P.O Box _____,

            __________, United Arab Emirates

Postal Code / Zip Code

Address Line 1:

Address Line 2:

City / State / Region:

Country of Residence

If your country is not listed here but you would still like to sign up for our loyalty programme please email us.

Address Preview

Please make sure the below address is correct

              ____________________________

              ____________________________

            Postal/Zip Code ______,

            __________,
            ____________

Web Access

Please select a password (minimum 5 characters, maximum 10)

Username:	Your Loyalty Card number will be your username
Password:
Re-enter Password

Your username and password will be emailed to you at the email address specified above.

Preferences

Finish

To finish, please verify the below words:

Sign Up for a Loyalty Card

Customer Details

Mailing Address

Web Access

Preferences

Finish