Mega Member
Information Changes and/or Card Requests

Have you moved?...Changed your name?...Need new cards?

What's the importance of updating my information?

This information is used for many different reasons:

• Mailing Patronage Refund Checks
• Returning lost Mega Member Cards
• Returning lost keys with Mega Member key-tags
• Verifying account information on card requests and special giveaways

So take a few minutes to do this now, it may come in handy later!

Current Mega Member Information
* Required
Name:*
Former Name (if applicable):
Address:*
Apt/Suite:
City:*
State:*
Zip:*
Primary Phone Number:*
Secondary Phone Number:
Email Address:
Mega Foods/Holiday Employee
Location: Select Store Mega Holiday Mega Lube Mega Foods Chippewa Falls Mega Foods East Ridge Mega Foods West Ridge
NEW Mega Member Information if moving or have moved Name: Address: Apt/Suite: City: State: Zip: Primary Phone Number: Secondary Phone Number: Effective Date of Changes: (mm/dd/yyyy) Card Requests (if applicable) Request Mega Member Card Set Member Number: Additional Notes:

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