Application Form

Instructions :

It is important to correctly choose the name of the branch where you want to fetch your Card U.
Once the application form has been sent, please call before coming to collect it at the welcoming desk of your Super U.

 

To collect it, please bring along your national identity card.
Please note that if the Card U is still not fetched two months after the application, it will be cancelled.

Form to fill in to receive your Card U.

Name of Supermarket: National Identity Card No: *
Title:
Surname: *
Name: *
Address: *
Date of Birth: *
Email:
Telephone No.: *

The following questions may allow us to better meet your expectations.

Profession:

Leisure and Passion: Gardening Traveling Do-it-Yourself Sewing Decoration Cooking Reading Beauty Sport Cinema Video, DVD Multimedia Car Fishing, Hunting Music Computer

Apart from Super U, which other super/hypermarket(s) do you go regularly?



Is Super U your main super/hypermarket? Yes No