VIP/Club Card Renewal Form

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VIP/Club Card Renewal Form

Please fill out the VIP Card renewal application form below and press submit button. We will process your application and contact you directly with telephone number you provided and confirm with you as soon as possible. If there is any question, please call us at Tel: (808) 924-3939/Fax: (808) 923-7517 or email us at vipapplication@zanzabarhawaii.com

A * indicates a required field.
All applications subject to approval .

*Card Type

VIP Card Renewal
Club Card Renewal

Price: $350.00
Price: ~~$175.00~~ $150.00

Payment required
once your application is
approved.

* First Name

Middle Initial

* Last Name

Company

Home Address

*Address

* City

* State

* Zip

* Country

Work Address

Address

City

State

Zip

Country

Please forward
correspondence to:

Home Work

Phone Numbers

* Home Phone (include area code)

* Work Phone (include area code)

Fax (include area code)

Birdthday

Month

Day

Year (Optional)

Favorite Drink

Occupation

* E-mail Address

Please ask any questions you might have and/or add any comments.

How did you find out about Zanzabar Night Club?

Other Source - Please Specify:

Authorized representative for phone-in reservations (VIP Card members only): (Optional)
Name:Affiliation/Title:

By submitting this application, you acknowledge that above information is true and correct to the best of my knowledge. By pressing the Send Form button below, I indicate understanding and acceptance of the Zanzabar Rules and Regulations and Terms and Conditions of VIP/Club Card membership..
* I agree.

ref no:4644

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