LowesFoods.com -- Rewards Card Application

Greenpoints® Enrollment Form
(You will receive two key tags and a card.)

Last Name:
First Name:
Middle Initial:
Street Address 1:
Street Address 2:
Apt:
Town/City:
State:
Zip:
Email:
Phone: (required for security and ID purposes)
Date of Birth: (for lost card and security purposes)
Number of persons in household including yourself
Mark this box if you do NOT wish to receive emails or mailings for special offers.
Information required for enrollment, as well as purchases, will be used to track earned and redeemed greenpoints and provide you with special offers. Neither Lowes Foods or S&H greenpoints will sell your personal information to third parties. Visit www. lowesfoods.com for a copy of Lowes Foods privacy policy and www.greenpoints.com for a copy of S&H greenpoints privacy policy. Participation in the S&H greenpoints program is subject to the terms of the S&H Membership Agreement. For more information go to www.greenpoints.com or call 1-800-435-5674. I understand that I am enrolling in the Lowes Foods Rewards program as an S&H greenpoints member.