Rain Bird Agency Rewards Program Enrollment Form

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Rain Bird^® Agency Rewards Program
Online Enrollment Form

Membership in the Rain Bird Agency Rewards Program is open to Public and Non-Profit Agencies in the United States and Canada only. Please provide complete information to ensure a fast response.

NOTE: All fields marked * are required.

	Non-profit Public Agency
* Agency Name:
* Contact Name:
* Address 1:
Address 2:
* City:
* State/Province:
Country	USA Canada
* Zip/Postal Code:
* Phone:
Fax:
E-Mail:
Primary distributor(s) where you buy Rain Bird products: (Please provide NAME and STATE/PROVINCE) NOTE: Products purchased from home centers and do-it-yourself stores such as Home Depot, Lowes, Ace Hardware, etc. are not eligible for this program. Visit our Turf Irrigation Distributor Referral page to find an authorized turf irrigation distributor near you.
* Distributor 1:		* State/Province:
Distributor 2:		State/Province:
Distributor 3:		State/Province:

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