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To request a card...fill in the form below. You can pick up a brochure at local participating merchants and mail it in... contact us for more options.

"Fill in this form and click "send" or print it off and mail, email or call in your information to request a HomeGrown Rewards card
(* fields in the form below are required - All info is kept confidential) 

-*First Name:

-*Last Name:

-*Address/Street/Apt.#:

-*City: *Province:

-*Postal Code: *Phone Number:

-E-Mail

-Date of Birth:

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