Benefit Card Application

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Thank you for your interest in joining the Dis-Chem Benefit Rewards Programme. Please complete the form to apply and collect your card in-store.

First Name*

Last Name*

Identity/Passport Number*

Date of Birth*

Email Address*

Cellphone Number*

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CUSTOMER CARE INFO

Feel free to reach out to our friendly Customer Care team:

Monday - Friday: 08:00am to 16:30pm

Saturday, Sunday and Public Holidays: Closed