Receive a $25 gift card

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2016 SUMMER SPECIAL Receive a

$25 gift card

when you purchase an eligible product from Bostrom Seating

Shown: LTSS

Shown: Wide Ride Core

2016 SUMMER GIFT CARD REBATE FORM (not payable at the retail) To receive your prepaid card by mail Buy: • An eligible product from Bostrom Seating between 8/1/16 and 9/30/16. Your request must be postmarked by 10/15/16. Receive a $25 gift card. Bostrom Seating • Bostrom Wide Ride Core • Bostrom+Serta Mattresses • Bostrom LTSS Mail: • This original form, completed • Original dated sales receipt(s) with store name(s) and product purchase price(s) circled

Rebate issued via prepaid card. Offer limited to US residents only, 18 years of age, or age of majority, or older. Limit one refund per name, household, or address. Use of multiple addresses or P.O. boxes to obtain additional funds is fraud and may result in prosecution. Prepaid card accepted where Visa cards are accepted. Not redeemable as cash or usable at ATMs or gas pumps. Card expires 6 months from issuance. Terms of prepaid card apply. Multiple submissions will not be acknowledged or returned. Rebate applies to price paid after any coupon or discount has been applied. This form must accompany your request. If a valid, original, dated receipt is not included in the request for rebate, your prepaid card will not be issued. Reproduction, alteration, sale, trade, or purchase of this official form or proof of purchase is prohibited. Proof of purchase must be obtained from product purchased by you. No requests from groups, clubs or organizations will be honored. We will not honor incomplete submissions. Not responsible for lost, late, or undelivered submissions. Please allow 8-12 weeks for delivery. Offer good only on purchases made between 8/1/16 and 9/30/16. Request for rebate must be postmarked no later than 10/15/16.

Address the stamped envelope to: SUMMER 2016 Rebate 7800 Walton Parkway New Albany, OH 43054

First Name:

Please allow 8-12 weeks for delivery of your prepaid card.

Address: Apt#:

Last Name:

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Date of Birth (MM/YY):

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