100 Shopping Rewards Points Free Bonus Redemption Voucher
  
Redemption Instructions:
To receive your FREE 250 Shopping Rewards Points bonus, please print this Redemption Voucher and complete the form below. Mail it to:

Club Benefit Network
Attention: 100 Shopping Reward Point Bonus
9420 Reseda Blvd., Suite 400,
Northridge, CA 91324

Satisfying the listed Purchase Requirement detailed on the previous page of your Membership Fulfillment Website is necessary. To verify you have satisfied the listed requirement, the Membership Number you list below will be checked to verify the purchase was made. Your 100 Shopping Rewards Points will be mailed to the address provided below within 1-2 weeks. You will then be able to accumulate and redeem the Shopping Rewards Points by visiting http://www.shoppingrewards.com. Limit one per membership number. Offer void where prohibited.

Name_________________________________   Address__________________________________________

City______________________________________________   State____________________   Zip_________

Email Address _______________________________________

Phone no (          )____________________________________

I have completed the listed purchase requirement.

Date Requirement was met_____/______/______ List Requirement Satisfied _____________________

Member Number _________________________________

Website Address of Your Member Fulfillment Website
__________________________________________