Superior Back to School Reward: July 23 - August 6, 2019

OFFICIAL REGISTRATION FORM

Name/Nombre: Address/Dirección: City/Ciudad: State/Estado: Zip/Código postal: Contact number/Teléfono De Dia: Email/Correo electrónico : Confirm Email:
Date of Birth/Edad - I am at least 18 years of age as of July 23, 2019 (Habré cumplido 18 años de edad al 23 de julio de 2019)
Instructions for Uploading Your Receipt:
1. Click the "Choose File" button below.
2. Find the image file of your receipt on your phone or computer.
3. Select Choose or OK.
4. Wait for the system to upload your receipt image.
5. Check the "I'm not a robot" box.
6. Click Submit.