STUDENT ADVANTAGE REBATE FORM

INSTRUCTIONS: To receive a $10 credit back to the credit card used to purchase your membership, please
complete this form and send with proof of purchase to receive your $10 rebate.

MEMBER FIRST NAME: _____________________________ MEMBER LAST NAME: _____________________________

STUDENT ADVANTAGE CARD NUMBER: _________________________________________________

(Find your Card number in the sample locations below)

STUDENT ADVANTAGE ENROLLMENT CARDHOLDER

PHYSICAL CARD CONFIRMATION PAGE HOMEPAGE

CARD NUMBER LOCATION CARD NUMBER LOCATION CARD NUMBER LOCATION

E-MAIL: ____________________________________________________________________________
(Please provide e-mail address to expedite rebate process)
PHONE:____________________________________________________________________________
(Please provide phone number to expedite rebate process)

SEND REBATE FORM AND PROOF OF PURCHASE WITH NATIONAL PARTNER TO:
Student Advantage $10 Rebate
950 Danby Rd, Suite 100C
Ithaca, NY 14850

Please contact Card Services at sa_rebate@cbord.com for assistance in completing this form.

Terms & Conditions

Proof of purchase from a Student Advantage national partner must be dated within 30 days of the date of membership in the Student Advantage program. All requests must be post marked
within 60 days of the date of membership in the Student Advantage program. Qualifying rebates will be processed as a $10 credit to the card used to purchase the Student Advantage
membership and will be fulfilled within 4-6 weeks following the submission date. Only one rebate is allowed per member, regardless of the number of memberships held in the Student Advantage
program. Incomplete forms or submissions will not be processed. Only memberships sold in conjunction with the $10 rebate offer will be eligible to receive the rebate. For help or inquiries,
contact us at sa_rebate@cbord.com.
Student Advantage® Discount Card is a registered trademark and product of Student Advantage, LLC.
Student Advantage reserves the right to verify your student status per the Cardholder Agreement you agreed to during enrollment.