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We ll still need to verify your identity so please leave us some contact information so we can call. Thank you for all your support VMD REWARDS 2663 SATURN ST BREA CA 92821 CONTACT INFORMATION YOUR NAME TELEPHONE EMAIL ADDRESS CITY FACEBOOK STATE ZIP INSTAGRAM WHERE DID YOU PICK UP THE JUICE WHAT IS YOUR FAVORITE VAPE SHOP WHICH REWARDS WOULD YOU LIKE TO CLAIM ADDITIONAL INFORMATION SIGNATURE DATE By signing this form I acknowlege that I am 18 years of age or older. VMDREWARDS CLAIM FORM YOU EARNED IT SEND COMPLETED FORM TO Thank you for being loyal to Vaping Monkey You re 1-step closer to claiming your reward. Fill out this form and add your labels to the following pages and send everything is. We ll handle the rest. Limited to eligible vapers 18 years of age or older we will verify. Shipping/handling charges may occur. For international participants shipping and handling is your responisbility. Actual products may vary slightly from image. Visit vmdrewards. com for details. VMDREWARDS 5-POINT SHEET TOTAL POINTS Place all 5-point labels on this sheet NAME PAGE OF. VMDREWARDS CLAIM FORM YOU EARNED IT SEND COMPLETED FORM TO Thank you for being loyal to Vaping Monkey You re 1-step closer to claiming your reward. Fill out this form and add your labels to the following pages and send everything is. We ll handle the rest. Limited to eligible vapers 18 years of age or older we will verify. Shipping/handling charges may occur. For international participants shipping and handling is your responisbility. Actual products may vary slightly from image. For international participants shipping and handling is your responisbility. Actual products may vary slightly from image. Visit vmdrewards. com for details. VMDREWARDS 5-POINT SHEET TOTAL POINTS Place all 5-point labels on this sheet NAME PAGE OF. Limited to eligible vapers 18 years of age or older we will verify. Shipping/handling charges may occur. For international participants shipping and handling is your responisbility. Actual products may vary slightly from image. Visit vmdrewards. com for details. VMDREWARDS 5-POINT SHEET TOTAL POINTS Place all 5-point labels on this sheet NAME PAGE OF.

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