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Go Rewards Membership Number

Please enter your 16-digit Go Rewards membership number. No spaces or hyphens.

Last Name

Your registered last name on the Go Rewards App.

First Name

Your registered first name on the Go Rewards app.

Date of Birth

Please select your birthdate from the calendar.

Type of Concern

Please select what type of concern you have from the choices given.

Mobile Number

Your registered Go Rewards mobile number. Please enter in this format: 09123456789

Email Address

Please enter your registered email address in your Go Rewards account. (ex: XXXXX@XXXX.com)