ITM - Priority Card Application Form

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#: