External Customer ID Customer Name* First & Last Name (This is how our Crew will look you up to add your next order to your Reward$!) Customer Cateogry Address 1 Example: 1330 Larpenteur Ave W Address 2 Suite or Apartment #, If None… Leave Blank Address 3 City State Example: MN (only 2 letter abbreviations please!) Zip Code Phone* This is for reference ONLY! We won’t call or text you! Email* Required to Receive Special Discounts Only Available to Reward$ Members! Do You Want to be Contacted About Special Discounts / Offers? Yes Please! No, I Don’t Want to be Contacted. (and I hate fun) Birthday Date Format: MM slash DD slash YYYY Anniversary The First Day You Ate Mac’s! Loyalty Balance
