Win With Caltex
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Please complete all the
required fields below:
MANDATORY FIELDS *
First Name
Last Name
ID Number
Cell Number
* Province you filled up in?
- Select -
Eastern Cape
Free State
Gauteng
KwaZulu Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
Which town within your selected province did you fuel up at?
Are you a resident or holiday/business traveller within the town you fuelled up at?
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Resident
Holiday/Business Traveller
Rate the service you received from your petrol attendant.
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Average
Good
Very Good
Do you want to receive promotional messaging from Caltex SA?
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Where did you hear about this promotion?
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Service Attendant
Social Media
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Billboard
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Other
* Upload a photo of your receipt.
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