Microsoft Cash Back Program

Thank you for taking the time to fill out the following online form. If you do not want to submit your information, click Cancel.

* Indicates a required field
*My name (personal information)
*First name
*Last name
Email address used under the Microsoft account must use a company domain and the company name must be the same as the name of the Reseller making a claim on the cash back portal.  Registration with a personal email address (hotmail/yahoo/gmail/ etc.) instead of an email address from a company domain will result in claims being rejected.

*My email address
Please confirm your email address
*Company/Organization Name
(200 char max)
*My business address
Department name
Job title
*Street address
*Postal code
*Payment currency preference - please select currency for your eligible claims incentive to be paid in

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