Midland BR10 Rebate Form
Thank you for your recent Midland purchase. Please complete the form to receive your business radio rebates for the purchase period of November 1 - December 31, 2026. All claims must be entered by December 31, 2026. Thank you.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Name
*
What best describes your business?
*
Please Select
Construction
Education
Hospitality
Manufacturing
Property Management
Restaurant
Retail
Sports
Warehouse
BR10 Model
*
Please Select
BR10X2
BR10X6
Date of Purchase
*
Image of Purchase Receipt
*
Browse Files
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Choose a file
Cancel
of
Image of Serial Numbers
*
Browse Files
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Choose a file
Cancel
of
I acknowledge this is for the purchase period of November 1 - December 31, 2026. All claims must be entered by Dec 31, 2026.
I Agree
Submit
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