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                                                                                                                                                        REBATE PROGRAM
.                                    REBATE PROGRAM APPLICATION                                   .

Simplex Offers Rebate credit to our clients based on total periodic sales volume.


Current Program- 2010 Calendar year

To enroll, please fill out the form below. We will then send you your rebate rates and rebate certificate.
First Name: *
Last Name: *
Company: *
Address Street 1:
Address Street 2:
City:
Postal / Zip Code:
Province / state:
Country:
Phone: *
Estimated Rebate Level ($sales/Year): *
Email: *
Comments:

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