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Customer First name: _________________________________________________

Surname: ___________________________________________________________

Customer email: _____________________________________________________

Customer Contact number: ________________ Mobile: ______________________

Customer card number: _____________________

I wish to unsubscribe from (circle) Email Direct Mail SMS

Please tell us why?

¨ I don’t remember subscribing

¨ I had hoped for more exclusive offers in the emails

¨ I only use specific products and not interested in others

¨ E-mails are coming too often

¨ The offers/types of contact do not interest me

Customer Signature Date: ______/______/________


Store/Office Use Only

Staff member Name: __________________________________

Customer Profile ID: _____________________ Customer Profile updated in POS: ¨ YES

Date: _____/______/_______

Print copy  - POS Works install request form_v2.pdf