Instructions:

1. Fill out this form
2. Print the completed form and attach Proof of Purchase copy
3. Mail to AERT, Advanced Environmental Recycling Technologies, Inc.
   PO Box 1237 | Springdale, AR | 72765

First Name:
Last Name:
Street Address:
City:
State
Zip / Postal Code:
Phone:	(Enter as 123-456-7891)
Deck #1 Dimensions:	by square feet
Deck #2 Dimensions:	by square feet
Receipt Number:
Deck Type:	ClassicPlusPremium
Date of Purchase:
Comments: