If you are human, leave this field blank.Distributor Company NameDealer Company Name *Contact Person @ Dealer *Email Address *Dealer Phone *Media Used *MagazineMailout FlyerNewspaperPhonebookPOP BannersPOP ClothingRadioTradeshow/Booth DisplayTV AdTotal Cost of Advertisement *Date (or start date) of Advertisement *End date of Ad - Please leave blank if ad was only run one day *Percentage of Ad to Manufacturer *Total Credit Amount *Please attach advertising invoice(s): *Copy or proof is mandatoryReminder• Co-op application forms must be submitted within 60 days of advertisement • Use one co-op application per advertisement • Include invoice for advertisement • Attach sample advertisement with proof of date • Print ads must contain the Enviro logo or the Enviro logo and photo • TV ads must display the Enviro logo in a prominent manner • Trade shows must display the Enviro logo in a prominent manner (photo of booth and list of products exhibited must be included) All credits are at the discretion of Enviro *reCAPTCHA is required.Submit
