Rebate Form

* Required fields need to be filled out. Please submit one rebate per activation.

* First Name:

* Last Name:

* E-mail:

* Wireless Phone Number Activated:

* Address:

* City:

* State:

* ZIP Code:

* T-Mobile Order Number:

* Promo Code:

Note: Rebates are only payable for qualified PAID lines that are active and in good standing 8-12 weeks after the first bill cycle date when processed