Jiffy Lube VIP Signup Form

Offer valid at participating Jiffy Lube locations only. Click here to see participating Jiffy Lube Locations. Welcome Jiffy Lube VIP! Thank you for your interest in the Jiffy Lube VIP Discount Program, a program that boosts employee morale without spending a single penny! We hope you and your employees enjoy the benefits of your VIP cards. Please fill out the information below and click "Submit." Your VIP cards will arrive in 2-3 weeks. Information in BOLD is required.
Company
First Name
Last Name
Address 1
Address 2
City
State (offer limited to states listed)
Zip Code
Business Phone Please include area code and extension
Number of Cards
Have you been to Jiffy Lube in the last 6 months?	Yes No
Does your business have 5+ vehicles? Jiffy Lube can help meet the maintenance requirements of your company vehicles. Our Fleet Services includes consolidated monthly billing and a local Fleet Manager contact. Would you like to learn more about Jiffy Lube Fleet Services?	Yes No
E-mail
Offer valid at participating Jiffy Lube locations only. Click here to see participating Jiffy Lube Locations. Offer may be withdrawn without notice.