Mailing List

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  New Customer

  Change Details

  Please remove from the Database


 

  Mr                 Mrs                 Miss                 Ms                 Other  
 

First Name

Surname

Postal Address

Town/City

Postcode

Email

Home Phone

Business Phone

Preferred method of contact

  Post

  Email

  Both

Mobile

Birthday (day / month)


 

Are you a Kirkcaldies Account Holder?

 

  Yes

  No

Account Number

Previous Address (if an address change request)


 

Areas of Interest

  Cosmetics
Please specify brand/s

  Hair and Beauty

  Fragrance

  Ladies Fashion

  Ladies Shoes

  Fashion Accessories

  Lingerie/Swimwear

  Menswear/Mens Shoes

  Childrenswear
DOB Child/ren

   

  Fine China

  Interior Decor

  Linens

  Furniture

  Stationery & Gifts

  Pens

    

  Food and Wine

  Kitchenware

  Luggage

  

Specific Database:

  

Submit Details


 

Privacy Statement: Kirkcaldie & Stains will not disclose customer details to a third party under any circumstance.
Should you wish your name to be deleted from our mailing list please telephone (04) 472 5899 ext. 637 or
email kirks@kirkcaldies.co.nz or ask at any counter instore.





165 - 177 Lambton Quay, Wellington
Ph (04) 472 5899
Email: info@kirkcaldies.co.nz