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Change of Address
Not receiving your coupon book? Have you recently moved and want to update your address? Fill out the form below to update your information.
Please fill out all of the fields below.
Bi-Mart Card Number:
Local Store Location:
First Name: Last Name:

(include your prior name)		 Prior Last Name:
Current Address:
City: State: Zip Code:
Prior Address:
City: State: Zip Code:
Additional Comments:
Please provide one or both of the following fields in case there are any questions about the information provided above:
Phone: (i.e. 541-555-1234) Contact E-Mail Address:
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