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Requested

Received

Incentive Request Form

Please provide details about your incentive request

Which of the following best describes your current status regarding buying a product?

I want to buy a product

A customer who has never purchased/subscribed to products or services before

I have bought a product

A customer who has previously purchased/subscribed to products or services

What type of incentive would you like to receive?

I would like to receive a cashback

Receive cashback on your purchase/subscription

I would like to receive a discount (Upcoming)

Receive a discount on your purchase/subscription

I would like to receive a gift (Upcoming)

Receive a gift with your purchase/subscription

Your incentive request message

Template suggestions (You are a Prospective Customer – Company) (1/4)

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