U-POL Spring Promotion Shop Redemption Form

Please use this form to redeem your free U-Pol t-shirt and earn an entry into the $2,000 weekend giveaway contest! The form must be completed in full and a PDF/JPG copy of the invoice with qualifying purchase must be attached to the submission. Incomplete forms may not be processed. If you have any questions, please email......

Purchase Requirement Reminder - Purchase 10 mix and match U-Pol #1 - #12 aerosols including at least e-coat and 2 qualifying filler products including at least 1 UP0686 Microfill, and get a free t-shirt!

This form will record your name, please fill your name. *

Shop Information

Please use this section to complete information to redeem the free t-shirt and earn entry into the weekend giveaway for shop technicians.

Shop Name *

Shop Technician First and Last Name *

Shop Technician Shipping address (must contain Address, City, State, and Zip) *

Shop Technician Email Address (for t-shirt tracking information purposes only) *

What is your t-shirt size? (Shirt sizing is unisex. If you have included more than one qualifying order, please list all sizes. *

Qualifying invoice (PDF or JPG file preferred.) *

Choose File

Distributor Information

Please use this section to complete information to redeem the free t-shirt and earn entry into the weekend giveaway for shop technicians.

Distributor Name *

Distributor Rep First and Last Name *

U-POL Spring Promotion Shop Redemption Form

Shop Information

Distributor Information

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