Participant Enrollment - Step 1

Please follow these instructions to complete your enrollment process:
  • If you click CANCEL your enrollment information will not be saved.

  • If you have trouble registering or have questions about the registration/confirmation process, please contact via email at or by calling Reward Headquarters at 1-866-431-9069.

    You must have Adobe Acrobat Reader intalled on your computer to finish the enrollment process. Click here to download a free version of Adobe Acrobat Reader.

    Please enter your account information for the following companies. If you do not have this information it is OK to leave it blank or enter it at a later time. However, if you do not provide this information we will not be able to process rewards for those sales.

    * My Medco Account#
    * Company Name  
    * Program ID #  
    * First Name  
    * Last Name  
    * User Class:
    * Country:
    * Address 1    
    Address 2
    * City    
    * State/Province
    * Postal Code    
    * County  
    * Phone  
    Mobile Phone
    * Email  
    * Confirm Email    
    * Username  
    * Password Case Sensitive  
    * Confirm Password    

    Need help on this site? Contact or call 815-407-3905.

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