291659 CLUB About You

Your hobbies and Interests 11-- ---- -- 41 11 -- --- --- 41 11 -- ---- -- 4

• M anda tory fields
*You are: SingleD MarriedO (if single p le ase proce ed to next section)
Personal Information
(Pleaseuse block letters only)
Wedding Anniversary (dd/mm/yyyy) ____________________________________________
*MrO MrsO MsO
Spouse Name ______________________________________________________________
*First Name ________________________________________________________________
Profession of Spouse _________________________________________________________
Middle Name -------------- ____________________________________________________
About Your Children (Dependents only)
*Family/Last Name-----------------------
Name Relatio Date of Birth
n (dd/mm/yyyy)
CNICNo.

*Nameto
appear on
card

*Date of birth (dd/mm/yyyy) _________________________________________________

*Profession _______________________________________________________________

Home Address You & K&N's

*Number & Street _________________________________________________________ Which K&N's Chicken Store(s) you usually shop at?

*City _____________________ Post Code _____________Province _________________

How often do you shop at K&N's Chicken Store(s)?
"Phone ____________________ Cell No. ____________________________________
More than 0 OnceaweekO Once in two 0 Once a month 0
once a week weeks
Email ____________________________________________________________________
You mostly buy: (ple ase check all that ap ply) Whole ChickenO Designer CutsO
*Your preferred mode for receiving club communication (eg account statement,
special offers etc) Boneless MeatO Ready-to-Cook 0 Fully Cooked
products 0
Email 0 Post 0 products
Your preferred mode of payment: Cash Credit Card 0
*Your preferred place for receiving club material (eg membership card,
other items)
0
Home 0 0 (If office is yaur pre ference, please
All above information will be retained and used by K&N's for The K&N's Way Club
communication. This information will not be shared with any third party.
Office fill o ut the fallo wing)

~
~ Organization ___________________________________________________________
I hereby confirm that I have read and understood all terms and conditions pertaining to
~ I Job Title/Department
1
~
Address: Number & Street -----------------

City Post Code __________________________________Province _______________

The K&N's Way Club Programme. I further confirm the terms and conditions pertaining
to the card, its possession and usage are unconditionally accepted by me. I acknowledge
that K&N's may modify or cancel The K&N's Way Club Programme at any time without
notice.

i" I Phone I
l~
l J Signatur Date
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