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-- Current clients --
- Please use this form for claiming your $25.00 BONUS Smith's Gift Card

Your Full Name:
Your Email:
Address to send your BONUS card :
Must be the same as on record with Novum
Your Study's BEGIN DATE:
Please specify as Month / Day
such as January 25th
Your Study's END DATE:
Please specify as Month / Day
such as February 10th
Note: this is after the final checkout AND your final visits - if any.
Your Phone Number:
Where did you see / hear Handy Dollars Advertisements?
Have you read Our Terms Of Service ?: YES - I have read and agreed to
Handy Dollar's Terms of Service

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