Gold Card Application Form

Title (Mr, Mrs, Miss etc etc) :
Forename (s) :
Surname :
Name of company (if applicable) :
Address :
Country :
Postcode :
Daytime Telephone Number :
Evening Telephone Number :
Mobile Telephone Number :
Email Address :
Website Address :
We will include you in our mailshot database for special offers. You will always receive our publication Sound & Lighting News every 3 months. Tick yes to be included for our other publication Karaoke News Update once every month or no if you have no interest in Karaoke.
	Yes No
Have you previously purchased any other items from Images Entertainments Superstore ?
	Yes No
If yes, how would you rate our level of service ?
	Excellent Good Fair Poor
By submitting this application, you confirm that you have read and agree to the Gold Card terms and conditions as specified here. You also agree that we may keep and use the information you provide along with your purchase history for the purpose of administering your account and for product marketing needs. We guarantee that we will never pass your personal details to another company for their own use.

Title (Mr, Mrs, Miss etc etc) :