Remittance Form

  • (Refer to the email with the link to this form for your Organization Code.)
  • Please type 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 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.