Please fill this form to enroll yourself into Sangam Mart Rewards program. After you fill this form please come to the store and pickup your MIC (Most Important Customer) card with your name and customer Id printed. Please use the card everytime you shop at sangam Mart and earn Rewards.

If you fill in your Date of birth we will send you a gift on your Birthday.

First Name	*
Last Name	*
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Date of Birth