Dealership Rewards Program | Autoplex | Northglenn, Loveland, Longmont, CO

Your Information

Name*

First Last

Cell Phone*

Only used to reach you when we have questions regarding rewards processing.

Email*

Dealership Name*

Autoplex Location (Where Work Was Completed) **

Birth Month*

Birth Day*

Important Note: Your birth month and day will be your 4-digit PIN# to activate your rewards card

Vehicle Year*

Vehicle Make*

Vehicle Model*

VIN Number*

Date of Install*

Products Installed*

Other Products

New or Existing Rewards Card*

Agreement to Terms*

I acknowledge that rewards may take up to 30 days after the work is completed to be processed and applied to my rewards card. Rewards must be submitted within 90 days from the time of completion. Any rewards submitted later than 90 days after installation is complete will be discarded.

Name

This field is for validation purposes and should be left unchanged.