T Home Executive or Passport number Employed Pensioner Do you have your prescriptions lled at Dis-Chem? Yes 10. Y Gender 7. 8. 9. No Date of birth Marital status 6. Y Y Y M Single Married Male M D D Divorced Other Female 11. 12. 13. Residential address 14. The Dis-Chem Bene t Card is issued by, and remains the property of, Dis-Chem Consolidated, who reserves the right to decline, issue and withdraw the card at any time. Dis-Chem reserves the right to alter or ame.
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How to fill out the Dischem Baby Club Application Form online
Filling out the Dischem Baby Club Application Form online is a straightforward process designed to help you access numerous benefits for you and your child. This guide will provide you with detailed steps to ensure a smooth application experience.
Follow the steps to complete the online application form successfully.
- Click the ‘Get Form’ button to obtain the application form and open it for editing.
- Provide your personal details including your title, surname, first name, and identity or passport number.
- Indicate your contact numbers, including home and work telephone numbers, along with your cell number.
- Fill in your email address and date of birth as requested. This information is essential for account verification.
- Select your marital status and provide details about your occupation and the number of dependents or children.
- Choose whether you have your prescriptions filled at Dischem, indicating 'Yes' or 'No'.
- Provide your residential address including the suburb, city, and postal code.
- Indicate your communication preferences, such as whether you would like to receive newsletters and vaccination reminders.
- Review the terms and conditions provided in the application to ensure you understand the membership's regulations.
- Once all fields are completed accurately, save your changes, then either download, print, or share the completed form as needed.
Complete your Dischem Baby Club Application Form online today and enjoy the benefits!
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