Gift Claim Form

Dream Car Road Rally

Thank you for playing the Road Rally game. Get the following information from your completed Road Rally game sheet—

  1. Enter the name and IPC account number below for each of the 13 drivers (for example, "John Smith # 1234567).

  2. Enter your mailing address and email.

  3. Click "Submit" to transmit your claim for a free gift.

See other "Important Details" below.

Red Driver

That's YOU!

Enter your name and IPC account number in red box

Blue Drivers

3 Persons that you personally introduced to AUTOship™

Gold Drivers

9 Persons that your Blue Drivers personally introduced to AUTOship™

 Drivers' Names and IPC Numbers                           

 

Your "Formal" Name (in the event you receive a personalized gift)

 

Your Mailing Address with City, State & Zip Code

 

Your Valid Email Address

 

How many different completed Game Sheets does this make for you?

  (Gift value increases with each additional game submitted)

 

  

Important Details

To qualify for your free gift, you must have 13 drivers included on the form. At the time the form is received, all drivers must be qualified AUTOship participants (120QV). All drivers must be different for each separate game sheet submitted. All data will be checked and verified. Please allow 3-6 weeks for delivery of your gift.

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