Please provide your program affiliation information. (Franchise or Corporate Head Office information)
Select one of the following Programs:
Noted Independent Service Centre business is currently enrolled in an ACDelco Program and wishes to cancel in order to register for the ACDelco Professional Service Centre member in the Retail Service Support Program or the ACDelco Retail Support Program. By clicking YES, you are agreeing to cancel from your current ACDelco program membership, as of this date, and proceed registering for the ACDelco PSC member in RSSP Program or ACDelco RSSP.
ACDelco PSC member in the Retail Service Support Program participants can receive their monthly rewards in one of two ways. Each ACDelco PSC RSSP member will be required to select from the following two reward options:
New ACDelco PSC RSSP members will have two weeks from registration to make their rewards selection from the list above.
The choice between these options is up to the account, and should depend on the needs of the business. Please select one of the two rewards options below.
Note: Changes to PSC RSSP rewards option are done once annually on a calendar year, and may not be changed outside of this time period.
If you currently have another business registered on the ACDelco PSC RSSP program and you would like to have the different membership put on the same rewards card, please ensure to notify us by contacting the Info-Line at 1-800-263-3526 after submitting the form. This applies to the Visa Rewards payment only and is not applicable to a rebate.
ACDelco PSC RSSP Rewards Points are made by ACDelco to the Business and it will be the sole responsibility of the Business Owner to report any taxable benefit conferred on any individual under the program that may be required under the Income Tax Act and to issue the requisite T4 and T4A information slips.
The undersigned Independent Service Centre (ISC) has read the terms of enrolment of the ACDelco Professional Service Centre member in the Retail Service Support Program and wishes to enrol in the ACDelco PSC Rewards Program. ISC will begin earning rewards on eligible purchases starting the month of enrolment in accordance with the ACDelco Professional Service Centre member in the Retail Service Support Program terms and conditions. The ISC understands that it must be enrolled in the ACDelco Professional Service Centre member in the Retail Service Support Program to be eligible to participate in the ACDelco PSC Rewards Program.
I would like to receive and be paid my ACDelco RSSP Rewards via:
Please note that the following information is required for the prepaid reloadable ACDelco PSC RSSP Visa Rewards card and the distributor rebate. A secondary rewards cardholder should only be provided if you selected the reloadable Visa card and want to add second cardholder (rewards are split between two cards).
1. Primary Rewards Contact:
2. Secondary Rewards Contact (Optional – splits rewards equally each month when Visa card is selected):
ACDelco reserves the right to change, add or delete Program Rules, redemption options and any related material at any time. ACDelco reserves the right to cancel the ACDelco PSC Rewards Program at any time without prior notice.
Sponsoring Distributor Name
Other Distributor Supplier Names:
Do you own more than one shop? You are required to attain a membership for each shop and pay the full membership fee for each individually addressed shop if you would like to earn rewards for each business’ purchases. Only shops officially registered and approved for the program will qualify for program benefits and rewards regardless if the shops are under the same corporation or owned by the same individual. This includes participation in program promotions.
Please list all technician names that should receive access to the training web site. An email address is required for the training web site registration.
Security Code
The ACDelco Professional Service Centre member in the Retail Service Support Program participant’s acceptance of this agreement signifies the ISC has reviewed the ACDelco PSC member in the RSSP fulfillment kit and agrees to its content including the Trade Mark and Service Mark License.
The ACDelco Retail Service Support Program participant’s acceptance of this agreement signifies the ISC has reviewed the ACDelco RSSP fulfillment kit and agrees to its content including the Trade Mark and Service Mark License.