Discount Card Application | McKeevers Chemists UK & N. Ireland

Discount Card

DISCOUNT CARD APPLICATION FORM

A DISCOUNT CARD WILL BE SENT TO YOUR PLACE OF WORK IF ELIGIBLE.

Discount cards are only available for staff employed directly by McKeevers Chemists, staff who work within and are directly employed by GP Practices or staff who work within and are directly employed by Nursing Homes serviced by McKeevers Chemists.

Please confirm your eligibility (read notice above):

I confirm I work for McKeevers Chemists

I confirm I work within and I am directly employed by a GP practice

I confirm I work within and I am directly employed by Nursing Home serviced by McKeevers Chemists

Name *

First

Last Name *

Last

Job Title

Home Address

Line 1

Line 2

City

County

Post Code

Email Address *

Enter Email

Confirm Email Address *

Confirm Email

Phone

Passport style picture (plain background) *

Maximum file size: 516MB

Please attach a .jpg, .png, .gif or .mpg image. By attaching an image to use as your profile picture you assert that you have rights to use the image and it is not illegal, pornographic or violent in any way.

Name of Work Place

Work Place Address

Line 1

Line 2

City

County

Post Code

By submitting this form, I confirm the details above are correct and I give P A MCKEEVER LTD consent to use my photo and use the information provided on this form to generate a discount card. I give my consent for P A MCKEEVER LTD to share my information with my employer listed under ‘Name of Work Place’ so that it may be validated. I also give permission to be added to all P A MCKEEVER LTD mailing lists so they may keep me informed of their current offers and promotions. I understand that any discount card given to me by P A MCKEEVER LTD can only be used by myself, the card will remain the property of P A MCKEEVER LTD and may be retained should it be used incorrectly by anyone else.

If you are human, leave this field blank.