MEMBERSHIP APPLICATION

Premium

Business

Primary Cardholder Information

Mr.

Mrs.

Ms.
Last Name

First Name

Middle Name

Sux

Name:
Day

Month

Year

Birthday:
No.

Street

Subdivision/Barangay

City/Municipality/Province

Home Address:
Mobile No.:

Email:

Landline:

Occupation:
If Business Application
Citizenship:

Business Name:

Filipino
Others, please specify country

How should we communicate with you?

Email

Mail

Mobile

Home Phone

Business Type:

Code:

Business Address:
Phone No.:
Business Email:

Extension Cardholder Information

Relationship to Primary Cardholder:

Mr.

Mrs.

Ms.
Last Name

First Name

Middle Name

Sux

Name:
Day

Month

Year

Birthday:
No.

Street

Subdivision/Barangay

City/Municipality/Province

Home Address:
Mobile No.:

Landline:

Occupation:

Citizenship:

Email:
Filipino

Others, please specify country

I certify that all the info above are true and correct.

Signature of Primary Cardholder

Date

Form No.:

BUSINESS EXTENSION

TERMS AND CONDITIONS

We are glad to welcome you as the newest member of the Landers Superstore
family. Here are your membership privileges and conditions:
1.

2.

3.

4.

5.
6.

Membership: Any individual above 18 years of age is qualified to apply

for membership. Membership application is bound by the rules of
Landers Superstore, which could be altered without prior notice.
Landers Superstore also reserves the right to refuse membership to any
applicant. Membership may be nullified without notice or cause.

Relationship to Primary Cardholder:

Membership Cards and Fees: The membership fee is covered for one
(1) year from the date of application of the Primary cardholder. The
membership card will expire on the anniversary date of the Primary
cardholder, as well as its Extension. The card is valid at any Landers
Superstore. For security purposes, you will be requested to show your
membership card upon entering Landers Superstores. You will likewise
be requested to show your membership card when paying at the
register. Lost or stolen membership cards should be reported
immediately to the Landers Superstore Membership Department. A
P100 fee will be charged for the replacement of each card. Membership
may be terminated at the discretion of Landers Superstore. All membership cards are non-transferable, remain as property of Landers
Superstore and must be surrendered upon request.

Name:

Renewal, Revision, or Deletion of Cards: The primary cardholder is

responsible and authorized for the renewal or any changes , including
deletion, of the membership. A notification will be sent to you for your
upcoming renewal each year. However, all primary cardholders must
pay the renewal fee, which can be done at any Landers Superstore.
Upon receipt of renewal fees, your membership will automatically be
extended for an additional one (1) yearand your membership card will
be replaced by a new one.
Termination of Membership: You may discontinue your membership
any time and we will refund your membership fee. To terminate your
membership, the Primary cardholder should submit to the Landers
Superstore Membership Department a written termination notice
together with the membership card, official receipt and any valid
identification card with photo. The refund will be pro-rated based on the
number of months remaining in your current annual membership.

Mrs.

Day

Warranty Policy: Landers Superstore honors all manufacturer's

warranties with respect only to locally-sourced items and/or products
manufactured within the Philippines. With respect to foreign-sourced
and/or imported items, the warranty of Landers Superstore shall be
limited.The Landers Superstore Warranty Policy does not apply to any
product, or part thereof, which has been damaged through electrical
voltage fluctuation, improper installation, misuse, alteration, attempts of
repair, neglect, accident, removal/defacement of factory seals or serial
numbers, damages from fire, flood, and wind or water.
General Policies: Landers Superstore promotes family bonding thats
why members are welcome to bring their children and guests. However,
only members are allowed to purchase merchandise using his/her
membership card. Responsible parenting is also encouraged inside the
superstore; children should not be left unattended. Opening of
merchandise before purchase is not permitted. Members are
responsible for any opened or damaged merchandise by their
guests, children or themselves. Landers Superstore reserves the
right to inspect backpacks, diaper bags or briefcases.

To ensure that you have been charged correctly for the merchandise received,
all receipts will be verified upon leaving the superstore. Landers Superstore is
not responsible for any damage or loss caused, directly or indirectly, by defects
in the merchandise manufactures or sold by other companies.
Landers Superstore does not assume the obligation of a depository or
safe-keeper of any vehicle and any content or part thereof while inside our
parking area. Landers Superstore members solely assume all risks to his/her
vehicle and its content when using the parking area. Therefore, Landers
Superstore is not responsible for any damage or loss to your vehicle while at the
parking area.
By submitting this membership application form, the applicant affirms that
he/she has read and understood the terms and conditions and gives his
unqualified conformity to these terms and conditions of membership.

Month

No.

Street

Subdivision/Barangay

Landline:

Occupation:

Citizenship:

City/Municipality/Province

Email:
Filipino
Others, please specify country

Signature of Primary Cardholder

Signature of Extension

Date

Extension Cardholder Information

Relationship to Primary Cardholder:
Mr.

Mrs.

Ms.

Last Name

First Name

Middle Name

Sux

Name:
Day

Month

No.

Year

Street

Subdivision/Barangay

Mobile No.:

Landline:

Occupation:

Citizenship:

City/Municipality/Province

Email:
Filipino
Others, please specify country

Signature of Primary Cardholder

Signature of Extension

Date

Extension Cardholder Information

Relationship to Primary Cardholder:
Mr.

Mrs.

Ms.

Last Name

First Name

Middle Name

Sux

Name:
Day

Month

Year

Birthday:
No.

Street

Subdivision/Barangay

City/Municipality/Province

Home Address:
Mobile No.:

Landline:

Occupation:

Citizenship:

Email:
Filipino
Others, please specify country

Signature of Primary Cardholder

For Landers Internal Use

Signature of Extension

Date

Membership Fee

Date:

Premium

P800

Method of Payment:

Business

P1000

Amount Paid:

Extension

P400

Remarks:
Date

Sux

Year

Mobile No.:

Membership Card No.:

Signature of Primary Cardholder

Middle Name

Home Address:

Home Address:

.
.

First Name

Birthday:

Return or Refund: The Landers Superstore member, his extension,

and Landers Superstore agree that return or refund is subject to the
following rules:

returned within seven (7) days from the date of purchase, along with
the original Landers Superstore sales receipt.
Non-food merchandise must be returned complete with original
packaging, manual and factory sales intact.
Undergarments are not returnable nor are they exchangeable. Items
considered as Service Center are not refundable and will be
returned to an authorized Service Center to repair under
manufacturers warranty.
Replacement or exchange of perishable items is only valid within 24
hours from date of purchase.
Food items to be returned should at least be 75% intact.

Ms.

Last Name

Birthday:

.
.

8.

Mr.

Payment: Payment can be made via cash, debit card or credit card
authorized by Landers Superstore.

. Replacement or exchange will be done in the Landers Superstore

the item was purchased.
. where
All defective merchandise for replacement or exchange must be

7.

Extension Cardholder Information

CDA Code: