Please fill out the appropriate information below to become an exclusive member of the Zax Mail™ Club! By joining today, you will receive exciting news, information and more straight to your inbox! And to show our appreciation for joining the club, we will mail you your member's only FREE Meal Deal Coupon.** *First Name: *Last Name: *E-mail Address: *Confirm E-mail Address: (consider using personal e-mail address as some employers block e-mail from outside organizations) *Birthday: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Don't worry, if you do not want to share your home address, you can still join the Zax Mail™ Club to receive all kinds of great news and updates via e-mail each month. But unfortunately without your mailing address, you won’t be able to receive the Free Meal Deal Coupon. I understand that by not supplying my home address, I will not receive the Free Meal Deal Coupon. Address: City: State: State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY *Zip: *Zaxby's is growing quickly, but is currently only located in the following 12 states – AL, AR, FL, GA, KY, MS, NC, OH, SC, TX, TN, VA. So although we may not have hatched near you yet, by joining our club and being a special member, you will know when we do! **Limit One Meal Deal Coupon Per Household. Zaxby's® respects your privacy and will not rent or sell your personal information.