Rebate Application Form

Purpose: 
To rebate administrative fees earned by NJPA from sales to its Full-voting Members, allowing these Members to use the funds to purchase further NJPA services or to make purchases off of NJPA bid contracts. 

Eligibility: 
The only NJPA Members entitled to participate in the rebate program are those Full-voting Members defined by Minnesota Statutes § 123A.21 Subd. 3 and § 471.59 Subd. 1 within Governor's Development Region 5, (Cass, Crow Wing, Morrison, Todd, and Wadena Counties) on record as of January 1, 2010.  
 
Please complete the form below to request your NJPA rebate.
* Full-voting Member Name:
* Address:
* Rebate Amount Requested:
(to be applied to Purchase Order)
 
* Purchase Order Number:
“I certify that the Rebate requested above will only be used for proper public and governmental purposes and agree to indemnify and hold NJPA, its employees and Board of Directors, harmless for any and all costs or liabilities incurred as a result of participation in this program.”
 
* Authorized Member Representative:
* E-mail Address:
Additional Comments:
* Required Fields

Disclaimer

This rebate program may be discontinued or modified at any time and for any reason by the NJPA Board of Directors with little or no notice to Full-voting Members. NJPA’s offering a rebate program at one time does not guarantee that a rebate program will be available in the future.  At no time shall Members be entitled to "cash out" their restricted account or use the funds in any manner other than to purchase further NJPA services or to make purchases off of NJPA bid contracts.