fundraiserapp docwilliams (5) (1) (PDF)

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Title: fundraiserapp-docwilliams
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Two Great
Membership Offers!


Earn 2% back on most BJ’s purchases.
Join by 4/817 and save $10 off the $100 annual Membership
fee, get two bonus months, a $20 BJ’s Gift Card** and save
10¢/gal. at BJ’s Gas for six months after opening.

Join by 4/8/17 and save $5 off the $50 annual Membership
fee, get two bonus months, a $10 BJ’s Gift Card** and save
10¢/gal. at BJ’s Gas® for six months after opening.

Please complete this application in full and return it to the Organization Rep at the address below, on or before the expiration date. Please
include a check or credit card payment for the full amount. Your membership cards can be picked up at the BJ’s Wholesale Hospitality
Center, 975 Bacons Bridge Road, Summerville SC, anytime after April 9th, 2017.

Organization Rep: Debbie Allen

Contact Number: 843-761-5266

Address: Doc Williams SPCA, 2673 So. Live Oak Dr, Moncks Corner, SC 29461

Offer Expires: 4/8/17
The BJ’s tent will be at Doc Williams SPCA on April 8 from noon to 4pm
All BJ’s Memberships are subject to BJ’s current Membership Terms, ask in-Club or go to

Choose Membership Level:

BJ’s Inner Circle Membership ____________

BJ’s Perks Rewards Membership _____________

Last Name ___________________________________ First Name ____________________________ MI _____ Sex



Mailing Address __________________________________________________________________________________________
City ________________________________________________ State __________________ ZIP Code ___________________
Phone # _____________________________________________

Market Code_______________________________________

Email ___________________________________________________________________________________________________
Every BJ’s Primary Member receives a second Membership Card for a household member at no additional
charge. If you choose to receive the second Household Membership Card, please complete the following:

(Note: Second Household Cardholder must reside
at the same address as the Primary Cardholder.)

Last Name ___________________________________ First Name _________________________________ MI ___________
Primary Signature — I understand that I am responsible for any checks and actions of the Second Cardholder.

please choose your method of payment. (Make checks payable to BJ’s Wholesale Club, Inc.)

My BJ’s Perks® Mastercard1®


American Express®

Credit Card Account # ___________________________ Expiration Date ______________

Discover® Network


Total Charge __________

BJ’s Use Only
BJ’s Sales Representative’s Signature _____________________________________________

Club # __________

Membership Expiration and Renewals: The month and year in which your Membership expires appear on your register receipts and on your “ My Account” page on
Date of Membership Purchase
Your Membership expires on the last day of the month and year shown. Paid Memberships renewed within two months after expiration will be extended 12 months from the
expiration date. Paid Memberships renewed more than two months after expiration will be extended for 12 months from the last day of the month of renewal.
*BJ’s Inner Circle® Membership fee is regularly $50; BJ’s Perks Rewards® Membership fee is regularly $100. This offer is not valid online or in-Club, may not be combined with other
offers, is not redeemable for cash and is only good for new Members and current Members renewing before expiration date. Nontransferable. Limit one offer per household. Photo
identification required when applying for Membership. Plus state and local taxes where applicable.
**BJ’s Gift Cards will be mailed to the address on file and may take up to 6 weeks to process. BJ’s Gift Cards are only for new Members; offer does not apply to renewing Members.
© 2016 BJ’s Wholesale Club, Inc. 21463017
My BJ’s Perks® Program is provided by BJ’s Wholesale Club, Inc., and its terms may change from time to time. Some exclusions may apply. Visit for Program Terms.
My BJ'
s Perks® Mastercard® is issued by Comenity Capital Bank, pursuant to a license by Mastercard International Incorporated. Mastercard is a registered trademark of Mastercard International Incorporated.

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