JOIN FOR FREE AND EARN
REWARD POINTS WHEN YOU SHOP!

Card Number: ______________________________

 

    

First Name: ________________________________

 

Last Name: _____________________________

 

Email Address: _____________________________

 

 Address: ___________________________

City: _____________________________________

 

State: _____________________________

 

Zip: ____________________

 
Phone (including Area/Country Code): _______________________________

Yes! Sign me up for a free Membership in the DHS Club and activate my ClubBucks Rewards Card.

Signature: ______________________________________

Check here to find out how you can earn money part time by giving out cards and having your own "work from home" business.

 

ClubBucks This Changes Everything!

***The DHS Club will only share your information with our authorized providers & representatives that perform certain services or functions on our behalf or as required by law. The DHS Club does not sell or rent your personal information to anyone.

REVISED 10/09/07