Special Discount Program

Special Discount
Registration Form

FIRST RESPONDERS, ACTIVE AND RETIRED MILITARY, NURSES AND TEACHERS:

Thank you for all you do! We want to show our appreciation by offering you an ongoing, everyday discount. Please fill out neatly & legibly to be entered into our First Responder Discount Program to start saving 10% OFF every visit. Provide all required information to ensure registration. Your phone number will be your discount code.

Personal Details

Name

Email

Phone

Which Nutrition Smart location do you shop at?

Which special discount will you be receiving?

Please specify First Responder, Military, Nurse or Teacher

Verification

Employer Name

Retired or Active

Employer Contact Information Address, City, State, ZIP Code

MUST SUBMIT VALID FORM OF I.D. FOR VERIFICATION

File upload

Delete all uploads

Choose files or drag here

Membership rules

FILL THIS FORM OUT. YOU MAY SUBMIT WITH PROPER I.D. ATTACHED OR PRINT AND BRING IT TO ANY OF OUR STORES (ID VERIFICATION WILL BE REQUESTED). YOUR PHONE NUMBER WILL BE YOUR CUSTOMER NUMBER. Disclaimer: Signing up does not guarantee your entry into the discount program. Membership will be verified. May take up to 1 week to get information processed and into the system, however with I.D. card you will always receive discount.

Verification