Redeem Your Data Focus Frequent Buyer Program Points

Thank you for using our Data Focus Online Frequent Buyer Program Order Form. You can also download a PDF version of the Frequent Buyer Program Order Form and return by mail or fax.

Certificates need to be ordered in units of $50 per retailer. Each unit can be made up of multiple certificates as offered by retailer.

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To ensure proper delivery of your gift certificate(s), please use a complete street address whenever possible.

Frequent Buyer Program Participant Information

Name *

Company *

Address *

City *

State *

ZIP *

Phone Number *

Email Address *

Where should we ship your Frequent Buyer Program merchandise? *

Ship to Above Address
Ship to This Following Address:

Name

Company

Address

City

State

ZIP

Daytime Phone

Evening Phone

American Express Gift Cheques

$25.00 - American Express Gift Cheques

$50.00 - American Express Gift Cheques

$100.00 - American Express Gift Cheques

Points Required

Data Focus Dollars

Qty - Data Focus Dollars

$

(Available in $50 incredments)

Points Required

TOTAL POINTS REQUIRED

CAPTCHA Code: *

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