IGA Kids Club Membership Update/Change of Details Form

Use this form to change the following registration details if: 

  1. Your personal details have changed , e.g. name, address, phone number, email address
  2. Your personal details on your IGA Kids Club membership card were incorrect, e.g. date of birth

 

 
Membership Number:*
First Name:*
Surname:*
Address:*
Suburb/Town:*
State: (Only available in ACT, NSW, QLD, SA, TAS, Vic & WA)*  ACT
 NSW
 QLD
 SA
 TAS
 VIC
 WA
Postcode:*
Are you a Boy or Girl?*  Boy
 Girl
Child's Date of Birth (Must be 12 years old or under on next birthday): INSTRUCTIONS: Press the 'select date' button. Use the << button to select previous years. Use < and > buttons to change the month. Then click the date of birth.*
Phone Number:*
Email Address:*
What would you like to update?
   
 
Required fields are marked with *.