ONLINE MEMBERSHIP FORM

Become a Zarraffa's Rewards Club Member today! Simply submit the form below, follow the prompts through to the payment section and we'll do the rest from there.

You'll receive your membership card, along with our terms and conditions for use, within 21 days* .

Remember to present your card with every purchase because every dollar you spend earns you valuable rewards!

Title:

Gender:

First Name:

Last Name:

Street:

Suburb:

State:

Postcode:

Phone:

Email:

(Providing us with your email allows you access to our online rewards site only, you can choose below if you do or do not want to be a part of our mailing list)

Date of Birth:* (This allows us to give you
a free drink on your birthday)

Age Range:

Which Zarraffa's Store do you frequent?

How often do you visit Zarraffa's?

Do you buy bulk coffee beans for your home or office?

Yes No

Is it Zarraffa's Coffee?

Yes No

If not which brand do you buy?

Yes* I would like to subscribe to Zarraffa's Coffee's mailing list to receive newsletters, promotional offers and updates.

At Zarraffa's Coffee we respect your privacy. Zarraffa's Coffee will not sell your details to any third party. However, your details may be provided to our suppliers for the purpose of producing promotional material on behalf of Zarraffa's Coffee. By completing and signing this application form you acknowledge this. Submission of this form confirms understanding of the changes to occur to the Rewards Program converting to the Z Card Program.

* Zarraffa's Coffee management reserve the right to refuse membership. Membership can be terminated at any time.

* denotes required field

ONLINE MEMBERSHIP FORM

Become a Zarraffa's Rewards Club Member today! Simply submit the form below, follow the prompts through to the payment section and we'll do the rest from there.

Please note