Loyalty program signup form
A loyalty signup form collects contact details and consent for communications — it does not itself issue card numbers, track points or process rewards. Those require integration with your own loyalty system. This form records who wants to join and gets you their email so you can send welcome messages. The connection between signup and your loyalty platform is work you do afterward.
The form beside this text is live. Fill it in and submit it — it validates exactly as it would for a real respondent, and saves nothing.
A form that collects signup, not one that issues loyalty numbers
This form records someone wants to join your rewards program and captures their email. Issuing a loyalty card number, tracking points and redeeming rewards all require your own system integration — the form is the intake, not the rewards engine itself.
Marketing consent as a required checkbox, not assumed
A required checkbox for email marketing consent with the actual consent wording as the label is what records exactly what the person agreed to. Never assume someone has agreed to receive email because they filled in their email address.
No card required.
Loyalty Program Signup
Live previewHow to build this form
5 steps in the editor. Nothing here needs a paid plan.
- Add text, email and optional phone fields for the customer's contact information.
- Add an optional date field for birthday if your program gives birthday rewards.
- Add an optional select field for "how you heard about us" to track where signups came from.
- Add a required checkbox asking consent to receive marketing emails — the legal requirement varies by region.
- Export to CSV to upload to your own loyalty or email platform.
Fields in this form
6 fields, using 6 of the 19 field types available.
| Question | Field type | Required |
|---|---|---|
| Full name | Short text | Yes |
| Yes | ||
| Phone | Phone | Optional |
| Birthday (for special offers) | Date | Optional |
| How did you hear about us? | Select | Optional |
| Consent to email marketing | Checkboxes | Yes |
What goes wrong with this form
Specific to a loyalty program signup form, not general advice about forms.
Assuming the signup form is the whole loyalty system
This form collects enrollment information — names, emails, consent. Loyalty numbers, point tracking and redemption are separate systems. Do not confuse the intake form with the platform that runs the program.
No consent checkbox for marketing emails
Even if your region does not require explicit opt-in, a required checkbox with the actual consent wording protects you legally and proves the customer agreed. Always include it and always make it required.
No way to track where signups came from
Add an optional "how did you hear about us" dropdown so you can see which marketing channels bring in new members. That column in the export tells you where to invest future marketing.
Questions about this form
Does this form issue a loyalty card number?
No — it collects signup info and email, which is what you need to enroll someone. Generating a card number and integrating with your loyalty platform happens in your own system after export. This form is the intake, not the whole enrollment process.
How do I send welcome emails to new members?
Export the form responses to CSV and upload to your email platform. You now have a list of new members who have consented to email — send a welcome message with their new member details or login instructions from there.
Can I collect birthday preference for rewards?
Yes — add an optional date field for birthday. If you offer birthday rewards, a date field is cleaner than free text like "dec 14" or "christmas", and it stays sortable in the export.