THIS FORM IS FOR NON-PROGRAM MEMBERS ONLY. ACDelco PSC, ACE AND RSSP MEMBERS: YOU DO NOT NEED TO REGISTER FOR THE PROMOTION AND YOU ARE AUTOMATICALLY ENROLLED. Registration Deadline: December 22, 2025HOW TO QUALIFY? Officially register for the promotion by completing the registration form below. Your shop must be registered to qualify. Buy a minimum of $500 in ACDelco parts AND 5 qualifying ACDelco batteries from an authorized ACDelco Distributor between December 1-31, 2025 and earn a $25 Ultimate Dining gift card. Buying more batteries will increase your Bonus! Reach the two purchase minimums and get $5 in gift card rewards for every additional battery purchased, up to a maximum of $125. Our batteries can be purchased from our authorized ACDelco Parts Suppliers. Qualifying gift cards (one gift card with your total earnings) will be mailed 6-8 weeks after the promotion ends to the owner and business address on file. Please ensure you fill out all fields of the registration form. Registration is required in order to qualify for this promotion.>>Click here for the full promotion information and guidelines. Question Title * 1. To qualify, you are required to register for this promotion. Please provide your full BUSINESS details. Full Name * Shop Name * Physical Business Mailing Address * Unit # (if applicable) City/Town * Province Postal Code Email Address * Phone Number * Question Title * 2. Please select the name of your primary ACDelco parts supplier. AUTO ELECTRIC SERVICE LTD - SK AUTO PARTS CENTRES/CANUSA - ON AUTOMOTIVE PARTS DISTRIBUTORS - AB/SK AUTOMOTIVE SUPPLIES - NL BENSON AUTOPARTS - ON/QC BOLTON AUTO PARTS - ON DIESEL AND AUTO ELECTRIC LTD - NS DIST. MOBUS PIECES D'AUTOS - QC FISHER AUTO PARTS - ON GENERAL AUTO PARTS - ON GUELPH AUTO PARTS - ON HOSIE & BROWN AUTO ELECTRIC - ON LES PIECES G R INC - QC LORDCO PARTS LTD - BC/AB NORTHWEST AUTO PARTS - ON PAT'S AUTO SUPPLY - BC/AB PIECES LE BON CHOIX - QC PISTON RING SERVICE SUPPLY - MB REGIONAL AUTOMOTIVE WAREHOUSING - ON RPG SUPPLY INC. - ON SPARK AUTO ELECTRIC CO LTD - ON VAST-AUTO DISTRIBUTION - QC VAUGHAN AUTOMOTIVE SUPPLIES - ON WORLDPAC - QC Other (please specify) Question Title * 3. How did you first hear about our promotion? Postcard/Mailing ACDelco Email Distributor/Sales Rep ACDelco Representative TechConnect Canada Website Friend/Colleague CONNECTION Application (InMail/Banner) Other (please specify) Question Title * 4. GM CANADA PRIVACY POLICYAt General Motors of Canada Company ("GM Canada"), we respect your privacy and value our relationship with you. Please contact us at 1-800-GM-DRIVE (1-800-463-7483) or view our Privacy Policy. ACDelco, a division of General Motors of Canada Company would like to periodically provide you with information on new products and services that are relevant to you based on information we have about you and use your information in accordance with our privacy policy. If you wish the information provided to be used solely to administer your participation in the contest, simply check the box. YES! I want to receive email and other electronic communications with news, offers and updates about products and services from ACDelco and General Motors of Canada Company that are relevant to my interests based on the information you have about me. I understand that I may withdraw my consent at any time. No - Opt Out for email and other electronic communications. SUBMIT
