* Choose one
* Select a store near you:
 
* Mercury Drug store where Suki Card will be picked up:

Allow 3 working days for pick-up of your Suki Card in your specified Mercury Drug store.

* Last Name:
* First Name:
* Middle Initial:
Gender:
Civil Status:
Blood Type:
* Mailing Address:
 
 
Birthdate:

(Month, Day, Year)

* Home Phone No.:
* Mobile No.:
* Email Address:
I agree to the Terms and Conditions of the Suki Card program.
By registering with the Suki Card program of Mercury Drug, supplying my Personal Data, and using the Suki Card, I hereby accept and agree to be bound by the terms and conditions of Mercury Drug Corporation’s Data Privacy Policy for the purpose of availing of Suki Card services and benefits, administration of my account, processing of any transaction using my Suki Card, and for other reasonable purposes which are related to my registration under the Suki Card program.

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