RPRegistration

Goodwin Bros. Rewards Pass Enrollment Form

PLEASE FILL OUT THE FOLLOWING INFORMATION WITH RESPECT TO THE VEHICLE TO BE ENROLLED IN THE Goodwin Bros. Lincoln Mercury REWARDS PASS POINTS PROGRAM.

AFTER COMPLETING THIS FORM, PRESS Register Me.

*Required Fields are denoted with an "*" asterisk.

Vehicle Purchase Information
Dealership Name
Contact Information
Vehicle Information

Please provide the following Vehicle Purchase Information:

Did you purchase this vehicle from the Goodwin Bros. Lincoln Mercury Dealership?

Yes No

Please choose the Dealership Name where you purchased your vehicle:

Please provide the following Contact Information:

First Name *

Last Name *

Company Name

Street Address *

Address (cont.)

City *

State *

Zip *

Work Phone

Home Phone

FAX

E-mail

Please provide the following Vehicle Information for the vehicle you wish to enroll in the Goodwin Bros. Lincoln Mercury Auto Group Rewards Pass Program:

Year * (YYYY)

Make *

Model *

Vehicle Information Number * (VIN)

Goodwin Bros. Rewards Pass Enrollment Form

Contents

CRA Marketing, Inc.
Copyright © 2003 [CRA Marketing, Inc.] All rights reserved.
Revised: 06/27/08.

First Name	*
Last Name	*
Company Name
Street Address	*
Address (cont.)
City	*
State	*
Zip	*
Work Phone
Home Phone
FAX
E-mail

*Year*	* (YYYY)
*Make*	*
*Model*	*
*Vehicle Information Number*	* (VIN)

Goodwin Bros. Rewards Pass Enrollment Form

Contents

CRA Marketing, Inc. Copyright © 2003 [CRA Marketing, Inc.] All rights reserved. Revised: 06/27/08.

CRA Marketing, Inc.
Copyright © 2003 [CRA Marketing, Inc.] All rights reserved.
Revised: 06/27/08.