Priority Card Application Form

Please complete the form below to apply for a ITM Priority Card,.

How did you hear of the ITM priority card?
 

Please confirm your contact details

Title*
First Name*
Last Name*
Occupation
Date of Birth
DD/MM/YYYY
Email*
Phone*
Mobile
Fax
Postal Address* Street Number & Name
  Suburb or RD Number
  Town/City
  Region
  Postcode*
Click here to find your post code.
Which Email Format do you Prefer?
  Text and Images (HTML)
  Text only
Login Details  
Password* Minimum 6 characters
Confirm Password*
Tell us a bit about your building requirements
Which is your preferred ITM Store?*
 
Which local Priority Partner would you like to support?
 
How much do you currently spend on average each month on building materials and tools?
 
Do you own or live on a farm, orchard or lifestyle block?
  Yes    No
How many hours a month would you spend on DIY?
 
Where do you go to find the latest advertised offers on building materials and tools?
 
TV
Magazine
Radio
Newspaper
Internet
Circulars/Brochures
Other
If Other please specify:
What other interests do you have?
 
Cricket
Golf
DIY
Fishing
Gardening
Netball
Motor Racing
Reading
Rugby
Rugby League
Sailing
Soccer
Travel
  I have read and understood the terms and conditions and privacy policy
 
STORE USE ONLY
Please enter the Priority Card # from the hardcopy application form here:
PC#: