Blue Chip Enrollment

Please fill out the enrollment form electronically. When it is complete, please print it and fax it to us at 918-665-5805.

For questions about the Blue Chip Program call Toll Free (in U.S. and Canada) 1-888-400-8877.

See Terms and Conditions.

Required Information is marked by an asterisk.  *

Residency U.S. & Canada residents International residents   Tell us about yourself Please enter your first name in the field below. The first name you specified is invalid. Your mist first name may only contain letters.   First Name  * MI Please enter your last name in the field below. The last name you specified is invalid. Your Last name may only contain letters.  * =  Required Last Name  * Your street address is required. Please enter a valid address in the field below. Address contains invalid characters. PO Boxes not allowed, physical address required. Address  * The second line of your address contains invalid characters. Address 2 Please enter the city in which you reside in the textbox below. City  * A postal/zip code is required. Your postal/zip code contains invalid characters. State AlbertaAlaskaAlabamaArkansasArizonaBritish ColumbiaCaliforniaColoradoConnecticutDistrict Of ColumbiaDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsManitobaMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNew BrunswickNorth CarolinaNorth DakotaNebraskaNewfoundlandNew HampshireNew JerseyNew MexicoNova ScotiaNorthwest TerritoriesNevadaNew YorkNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandQuebecQuebecRhode IslandSouth AustraliaSouth CarolinaSouth DakotaSaskatchewanTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingYukon Territory * Zip/Postal Code  * Country United StatesCanadaGuamMicronesiaMarshall IslandsMarianna IslandsPuerto RicoSamoaUs Virgin Islands * You need to fill the area code of your phone number. Your phone number's area code should contain only digits. You need to complete the first 3 digits of your phone number The first 3 digits of your phone number contain characters other than digits. You need to complete the last 4 digits of your phone number. The last 4 digits of your phone number contain characters other than digits. Home Telephone    * Date of Birth JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  12345678910111213141516171819202122232425262728293031   2002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900  * Gender MaleFemale * An e-mail address is required to enroll in Blue Chip. Please enter your address in the text box below. The E-mail Address you specified is not valid. E-mail  * Language Preference EnglishFrenchSpanish * YES. I would like to receive notification of Thrifty.com special offers and promotions. Create a password (enter up to 15 characters) You need a password for your account. You need to confirm your password Password  * Confirm Password  * About your Company   > Learn More Company Name Company Telephone The Corporate Discount Number you specified is invalid. Thrifty Corporate Discount Number    Form of Payment Preferred Form of Payment    Select Form of PaymentAmerican ExpressCarte BlancheDiner's ClubDiscoverMaster CardThrifty Billing AccountVisa   *   Credit Card Required at Time of Rental A credit card number is required. Please choose a type of credit card. The credit card number you specified was not valid. Credit Card #  * Expiration Date JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  20062007200820092010201120122013201420152016 * Alternate Form of Payment    Select Form of PaymentAmerican ExpressCarte BlancheDiner's ClubDiscoverMaster CardThrifty Billing AccountVisa   Credit Card Required at Time of Rental Please choose a type of credit card. The credit card number you specified was not valid. Credit Card # Expiration Date JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  20062007200820092010201120122013201420152016 Rental Information You need to provide a Drivers License #. You need to enter a valid Drivers License #. Driver's License State/Province AlbertaAlaskaAlabamaArkansasArizonaBritish ColumbiaCaliforniaColoradoConnecticutDistrict Of ColumbiaDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsManitobaMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNew BrunswickNorth CarolinaNorth DakotaNebraskaNewfoundlandNew HampshireNew JerseyNew MexicoNova ScotiaNorthwest TerritoriesNevadaNew YorkNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandQuebecQuebecRhode IslandSouth AustraliaSouth CarolinaSouth DakotaSaskatchewanTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingYukon Territory * Drivers License #  * Driver's License Expiration JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 * Preferred Car Type Compact CarIntermediate CarFull-size CarLuxury CarMinivan By clicking to select any of these options you will automatically be charged the associated fees at the time of your rental Damage Waiver Liability Protection Personal Accident Insurance and Personal effects protection / Protection Plus Services (Canadian Residents Only) Pre-paid Fuel Rewards, Frequent Flyer or Loyalty Programs What are Blue Chip Rewards?   Check here to make BLUE CHIP REWARDS your preferred loyalty program. See Terms and Conditions. InvalidLoyaltyProgramAccountNumber Preferred Airline or Loyalty program Loyalty ProgramsAlaska AirAmerica WestAmerican AirlinesBlue Chip RewardsContinentalDelta AirlinesGulf AirHBC RewardsIcelandairKuwait AirwaysLatin PassNorthwest AirlinesQantas AirUnited AirlinesUS Airways Account# InvalidLoyaltyProgramAccountNumber Additional Airline or Loyalty program Loyalty ProgramsAlaska AirAmerica WestAmerican AirlinesBlue Chip RewardsContinentalDelta AirlinesGulf AirHBC RewardsIcelandairKuwait AirwaysLatin PassNorthwest AirlinesQantas AirUnited AirlinesUS Airways Account#

Finished? Print this form with your information and fax it to us at 918-665.5805.