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Dealership Rewards Program
Autoplex Dealership Rewards Program
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) *
*
Please Select Location
Longmont
Loveland
Northglenn
Birth Month
*
01 (Jan)
02 (Feb)
03 (Mar)
04 (Apr)
05 (May)
06 (Jun)
07 (Jul)
08 (Aug)
09 (Sep)
10 (Oct)
11 (Nov)
12 (Dec)
Birth Day
*
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
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31
Important Note:
Your birth month and day will be your 4-digit PIN# to activate your rewards card
Vehicle & Product Information
Vehicle Year
*
Vehicle Make
*
Vehicle Model
*
VIN Number
*
Date of Install
*
Date Format: MM slash DD slash YYYY
Products Installed
*
Headrest / Overhead DVD
Leather
Heated Seats
Katzkin Degreez (Heated & Cooled Seats)
Sunroof
Other
Other Products
New or Existing Rewards Card
*
I have an existing Rewards Card
I need a new 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.