Customer Contact Enrollment Form

Dear Valued Concessionaires:

As part of our commitment to deliver unparalleled customer service among our concessionaires, we wish to collect your contact information to deliver up to date announcements and billing details to your mobile phone through text or e-mail.  

We assure our concessionaires that your right to privacy is protected in accordance with RA 10173 otherwise known as Data Privacy Act of 2012.  PIWAD shall use your personal information to fulfill the above purpose, it shall not be used to any purpose that is contrary to law or in any manner which you were not notified of.

 Thank you.
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Email *
Account Name *
Code Number *
Account Number *
Please follow this format: 111-23-4567
Email Address *
Contact Number *
Only one contact number per account will be registered
I agree to register my contact details to receive: *
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