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2. 
4. To apply for the Rachio Spinkler Controller Rebate please complete the information below, upload your receipt and submit application.
6. Name:*
7. Account Number (xx-xx-xxxxxxx-xx):*
9. Service Address: *
11. Email: *
12. Phone Number:*
14. Dollar amount of irrigation controller purchased:*
15. Upload Receipts:*
19. For office use only:
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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

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