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SPOT, CONNECT & WIN PROMOTIONAL INQUIRY FORM

Today. Tomorrow. Together

SPOT, CONNECT & WIN PROMOTIONAL INQUIRY FORM

Name

CUSTOMER INFORMATION

Are you currently a CAPITA customer?

PROMOTIONAL INTEREST

What product are you interested in?

SPOT, CONNECT & WIN

Have you already submitted your Spot, Connect & Win entry to CBC?

Referral

How did you hear about this promotion?

CONSENT

I have read and agree to the Terms & Conditions.(Required)
I consent to CAPITA Financial Services contacting me regarding this promotion and related products and services.(Required)
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