Prize Selection Form

Complete each of these sections, then press the 'Submit' button

to request the prize you've selected from the

SAFESTART Award of Excellence catalog.

Part 1 - Identification Numbers

Your Company ID Number:

(5 digits)
Your Company Name:
Your Employee ID Number: (up to 10 digits)

The winning member's

Family ID Number:

 (1 digit)
 
Part 2 - Your Shipping Address
Your Name:
Street Address:
Apartment/Unit Number:
City:
State/Province:
Zip/Postal Code: (ie. H0H 0H0 or 90210-0123)
   
Daytime Phone Number: (include area code)
Home Phone Number: (if different from above)

 

 

 

Part 3 - Your Prize Selection(s)
You can win more than once! Enter up to 5 prize items below based on the prize levels you were told on the Awards hotline when you won.  
Item (10 digits) Description Color Size Prize Letter
1
2
3
4
5

 

Part 4 - Verify and Submit

Once you have entered and verified all of your information please print a copy of this completed form for your records, then press the Submit button below to send us your prize submission.

 

Before you place your order, please note:

Manufacturers may discontinue items without notice at any time.  You will be notified if an item you selected is no longer available.  You will be able to select another item at the same prize level from the SAFESTART Award of Exellence catalog PDFs on this page.

 

Some of these items will ship directly from our warehouse, while others will be shipped to you from the manufacturer.  Items may arrive at different times.  Over 95% of all orders will arrive in 2 to 6 weeks.  If your order hasn't arrived and it's been over 6 weeks, please contact us at:

1-800-275-9171  or  orders@awardofexcellence.com

 

 

 

 

 
     

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SafeStart is a registered trademark of Electrolab Ltd.