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This offer is available for new agreements signed
5-1-15 through 11-1-15.
Publisher reserves the right to cancel this offer at any time.
Signing up with a New LifeStyles
Home Care or Hospice Provider?
We owe you
$50!
Please complete all fields:
Name: _____________________________________________________
Address: _____________________________________________________
City: ________________________ State: ______ Zip Code: ________
Phone: _____________________________________________________
(this information will not be shared)
Provider Name: _______________________________________________
Date Used: _______________________________________________
Yes!
I have signed up for service.
I want to take advantage of this one time offer!
Simply say, "I found you in New LifeStyles" when you sign a
new agreement with a service provider advertising in this guide
(see page 17). Once 8 hours of service is verified,
we will send you a check for $50!
Submit your information via one of these methods:
1. Mail this form to:
New LifeStyles, 4144 N. Central Expressway, Suite 1000, Dallas, TX 75204
2. Email the required information to: newlife@newlifestyles.com
3. Submit your request online: www.NewLifeStyles.com/rebate
