Loyalty Scheme Application

Please fill in this form to apply for our Loyalty Scheme

TitlePlease selectMrMrsMsMissDrOther

If other please state

Previous Customer:Please selectYesNo

Surname or Company Name

House No. / Name

Postcode

Vehicle Reg. No.

Email Address *

Mobile Number

Loyalty Card No. (Can be found on the Autoshack side of your card)

If you require any extra cards in your household, please advise of how many?

Apply

Your unique loyalty number will be entered onto our system as your unique customer account number, your loyalty card, OR loyalty number must be produced at the time of your enquiry.