First Name*

Last Name*

Trading Name*

Property Name

Address*

Town*

State/Territory *

Postcode*

Phone*

Country*

Customer Email Address*

If no email address, please enter your name followed by @noemail.com. e.g. johndoe@noemail.com

Store Name*

Store Town*

Store Phone*

Product*

Date of purchase*

Invoice Number*

Volume purchased (in Lts)*

Tick this box if you DO NOT wish to receive emails from Corteva Agriscience

By submitting this claim, you agree to the promotion’s terms & conditions.

Terms and Conditions:

Only purchases invoiced from participating resellers between 1st May 2023 and 30th June 2023 are eligible.
Claims received after 11:59pm on 30th of June are not eligible.
Claim information must include full details as requested on the claim form to be eligible.
Receipt or invoice must be retained as proof of purchase. A copy of invoice and transaction history from store may be requested for inspection.
Bonus Goods will be sent to the store where product was purchased from, within a month of the claim being submitted.
This promotion is not available in conjunction with any other promotion or offer.
Employees of Corteva Agriscience, their families and resellers are ineligible to enter.
This promotion is subject to stock availability.
You may enter only once per purchase. Multiple claims are allowed per claimant.
A maximum of 160L can be claimed for each product for the duration of the promotion.

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