Shopper Rebate Form

Rebate Request Form

  • Email used with the rebatejet system
  • Your mobile phone number used to sign up
  • Date Format: MM slash DD slash YYYY
    Date you purchased the item on Amazon
  • Your Amazon Order Number
  • Accepted file types: jpg, gif, png, pdf.
    Take a screenshot of the Amazon order so we can verify you made the purchase. Please include the price paid in the photo.
  • Accepted file types: jpg, gif, png, pdf.
    Take of a photo of the product in your possession.
  • As our check system is no longer functioning, we will send all rebates via Paypal.
  • This field is for validation purposes and should be left unchanged.

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