Each participating school will receive a 3% CASH rebate on all—participating members local monthly service fee*—every month. Please complete form for each wireless number to participate in our School Rebate Program.

Account Name:

Farmers Mobile Number: Main Line or  Shared Line

Address:

City , State and Zip

Your School Rebate Choice - School Name

Are you a: Teacher    Employee    Student    Parent or Other

* Qualified rate plans of $29.95 or higher on primary line, and access for all additional lines.