Chaizer Snap-Shopper

Personal Details

Surname:
First Name(s):
Date of Birth:
Home Telephone:
Cellphone:
Home Address:
Previous Address:
Own
Rent
New Zealand Citizen
New Zealand Resident
Email:

Employment Information

Employer:
Telephone:
Contact:
Position:
Currently employed for how long?
Average Annual Income:
Previous Employer:
Previous Position:
Previously employed for how long?

Financial Information

Why this information is required:
Chaizer™ Snap-Shopper Club Members may be eligible to apply for financial assistance to purchase major items such as household appliances and/or automobiles. The information supplied in this Application will only be used for Membership assessment.
Further information will be required prior to financial products being made available should you be selected as a Chaizer™ Snap-Shopper Club Member.

Which Bank(s) do you hold an account with?

ANZ

BNZ

Kiwibank

Westpac

National

Other

Which Credit Cards do you use?

AMEX

DINERS

VISA

MASTERCARD

Other

Computer Information

Chaizer™ Snap-Shopper Club Members will be issued with electronic equipment including a Chaizer™ keyring scanner and a computer interface and operating software for automatic email feedback of scanned images. Applicants for Chaizer™ Snap-Shopper Club Membership must complete details about the computer system they currently use.

Home Computer?
Make/Model:
Internet Service Provider:
Wired Modem
Wireless Modem
High Speed Internet (up to 2Mbps)
Low Speed Internet (up to 500Kbps)
Hard Drive Size:

Brief Terms and Conditions

Chaizer™ Snap-Shopper Club Members will save on purchases of goods and services. There is a fee of $10.00 per month to remain a Chaizer™ Snap-Shopper Club Member. This fee entitles the Club member to be provided with a Chaizer™ keyring scanner and operating software. A personal Provedore looks after Members’ requirements. Direct factory access to consumer goods at special prices, financial services for hire purchase or lease arrangements are made available. For a further $10.00 per month Chaizer™ Snap-Shopper Club members can include an automatic call service for personal assistance.

Completion of this Application does not automatically guarantee Chaizer™ Snap-Shopper Club Membership.

A Membership Agreement Pack will be sent to you once eligibility criteria is confirmed.

I have read and agree to the Brief Terms and Conditions