Customer Rewards

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Please enter your full name (Required.)

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Birthday (mm/dd/yyyy) - This will be your reference code (Required.)

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Please enter your email address for confirmation (Required.)

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Mailing Address (Required.)

Please enter your label counts below - if none, enter "0"

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How many green labels (10 pts each) are you redeeming? (Required.)

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How many silver labels (15 pts each) are you redeeming? (Required.)

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How many black labels (20 pts each) are you redeeming? (Required.)

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Total points from all labels (Required.)

Please Select Your Reward Item

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Green Tier - 200 Points per item

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Silver Tier - 400 Points per item

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Black Tier - 750 Points Per Item

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Select your size (if applicable)

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Dispensary of Choice

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* By submitting this form, you agree to receive Ilera updates, new product drops, and rewards news by email or text. Don’t worry — we only send the good stuff, and you can unsubscribe anytime. (Required.)

Yes

Please write the reference code on the back of the envelope

Customer Rewards

Question Title

* Please enter your full name (Required.)

Question Title

* Birthday (mm/dd/yyyy) - This will be your reference code (Required.)

Question Title

* Please enter your email address for confirmation (Required.)

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* Mailing Address (Required.)

Question Title

* How many green labels (10 pts each) are you redeeming? (Required.)

Question Title

* How many silver labels (15 pts each) are you redeeming? (Required.)

Question Title

* How many black labels (20 pts each) are you redeeming? (Required.)

Question Title

* Total points from all labels (Required.)

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* Green Tier - 200 Points per item

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* Silver Tier - 400 Points per item

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* Black Tier - 750 Points Per Item

Question Title

* Select your size (if applicable)

Question Title

* Dispensary of Choice

Question Title

* * By submitting this form, you agree to receive Ilera updates, new product drops, and rewards news by email or text. Don’t worry — we only send the good stuff, and you can unsubscribe anytime. (Required.)

Please enter your full name (Required.)

Birthday (mm/dd/yyyy) - This will be your reference code (Required.)

Please enter your email address for confirmation (Required.)

Mailing Address (Required.)

How many green labels (10 pts each) are you redeeming? (Required.)

How many silver labels (15 pts each) are you redeeming? (Required.)

How many black labels (20 pts each) are you redeeming? (Required.)

Total points from all labels (Required.)

Green Tier - 200 Points per item

Silver Tier - 400 Points per item

Black Tier - 750 Points Per Item

Select your size (if applicable)

Dispensary of Choice

* By submitting this form, you agree to receive Ilera updates, new product drops, and rewards news by email or text. Don’t worry — we only send the good stuff, and you can unsubscribe anytime. (Required.)