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Claiming Coupon Form Template

Create engaging coupons to boost customer loyalty

Struggling to attract customers with discounts can limit your business growth. This Claiming Coupon Form Template is designed for businesses like yours that want to efficiently manage coupon distribution and ensure customers can easily claim their discounts. With features like full customization, easy tracking of coupon usage, seamless integration with marketing campaigns, and WCAG-aligned accessibility, you can create an inviting experience for your users. Start using the live template and see how straightforward coupon claiming can be.

Which type of coupon are you claiming today?
Percentage discount
Cash discount
Free shipping
Free gift
Other/Not sure
Coupon code (if you already have one)
Preferred delivery method for your coupon
Email
SMS text message
Both Email and SMS
What products or categories are you most interested in?
Apparel
Electronics
Home and kitchen
Beauty and personal care
Grocery
Sports and outdoors
Prefer not to say
Other
Please Specify:
Full name
Email address
Phone number (optional, required for SMS delivery)
How did you hear about this coupon?
Email from us
SMS text from us
Social media
Friend or family
Search engine
In-store signage
Website banner
Prefer not to say
Other
Please Specify:
I agree to the coupon terms and privacy policy
True
False
Type your full name as your signature
Signature date
I would like to receive occasional offers and updates
Yes
No
{"name":"Which type of coupon are you claiming today?", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Which type of coupon are you claiming today?, Coupon code (if you already have one), Preferred delivery method for your coupon","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration featuring a coupon form with a creative design for Claiming Coupon Form Template article.

When to use this form

Use this form when you run a limited-time promotion and need a simple way to verify eligibility and deliver a discount code. It works for ecommerce drops, in-store flyers, or social ads that promise a code after sign-up. You collect contact details, confirm which offer the person wants, and send a single-use code while tracking redemptions. To build your list at the same time, add an opt-in checkbox and connect it to the Email signup form or the Join our mailing list form. You will reduce fraud, keep one redemption per person, and give customers a fast, clear path to claim their savings online or at the register.

Must Ask Claiming Coupon Questions

  1. Which offer are you claiming today?

    This tells you which promotion to honor and applies the correct rules or expiration. It prevents people from mixing offers and keeps your reporting clean.

  2. Do you have a coupon code, or are you requesting one?

    If they already have a code, you can validate it; if not, you can issue one automatically. This reduces confusion and speeds up fulfillment.

  3. What email address should we send your code to?

    You need a reliable address to deliver the code and keep a record of consent. For longer follow-ups or support, you can route messages through the E-mail submission form.

  4. Would you like to receive the coupon by SMS?

    SMS delivery is fast for in-store use and mobile checkout. Collecting opt-in here helps you comply with messaging rules; you can manage this with the SMS Opt-in form.

  5. Do you agree to the coupon terms and eligibility rules?

    A clear agreement sets expectations for limits, exclusions, and timing. It protects you from disputes and helps enforce one-per-customer policies.

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