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Remittance Form

  • (Refer to the email with the link to this form for your Organization Code.)
  • Please type below the Name of your Organization exactly as it should appear on your rebate check so your treasurer will be able to deposit it.
  • Please type below the full Name and Mailing Address for the location where we will mail your rebate check. To ensure delivery, please provide this information here even if it is the same as the address you gave us during registration.
  • IMPORTANT NOTE: To help us avoid bank charges and additional processing time required to replace a lost/missing check please give careful consideration to who will open the mail at the address you provide and then communicate with individuals in the office and/or your organization's treasurer so the check will be promptly deposited.
  • Checks expire after 90 days.