highlife Corporate - Existing Member Discount Request

Please complete the form below to request a corporate membership discount be applied to your highlife account.

1. Forename *This question is required.

2. Surname *This question is required.

3. Your email address *This question is required. This question requires a valid email address.

4. Your phone number *This question is required. (in case of query)

5. Date of Birth *This question is required. This question requires a valid date format of DD/MM/YYYY.

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6. Home Postcode *This question is required.

7. Your highlife Membership Number This question requires a valid number format.

8. Organisation Name *This question is required.

9. Are you required to submit your payroll number or a discount code to request a highlife discount? *This question is required.

10. Your Payroll Number *This question is required.

10. Your Discount Code *This question is required.