LUXEROSE VIP CLub Application Form

Takeout Benefits

Free regular hot coffee with any cabinet purchase above $6.

Free coffee for every 5 coffees purchased.

50% credit every meal up to $500 NZD on Monday to Friday.

Get back $50 credit for referring your friend to join in our VIP club.

Join in Luxerose’s VIP club today and enjoy the Take out and Dine in Benefits!

Fill in the blanks below to set up your VIP account and get your member account ID number!

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Your Title*

First Name*

Last Name*

Street Address*

Email*

Suburb*

City*

Post Code*

Phone Number*

Date of Birth*

Today's Date*