MEGALAC Step Up Program Enrollment Form

To qualify for the MEGALAC step up program, producers must meet the following criteria:

Must be a new MEGALAC^® customer. Only producers who have not fed MEGALAC during the Program Period (i.e. 2019) will qualify for a $100/ton rebate on all new MEGALAC purchases from January 1, 2019 through December 31, 2019.
Must be a new ESSENTIOM^™ customer. Only producers not currently feeding ESSENTIOM will qualify for a $200/ton rebate on all new ESSENTIOM purchases from January 1, 2019 through December 31, 2019.
Submit enrollment form to your ARM & HAMMER^™ representative or Dawn Ehlers (Dawn.Ehlers@churchdwight.com) for verification and program confirmation.

* All fields are required

Dairy Name

Producer Name

Address

City

State

ZIP Code

Phone (###-###-####)

Products Incorporated

MEGALAC

ESSENTIOM

Number of cows eating MEGALAC every day

Feeding rate (lbs/cow)

Number of cows eating ESSENTIOM every day

Feeding rate (lbs/cow)

Nutritionist

Feed Supplier

Start Date (mm/dd/yy)

ARM & HAMMER will rebate $100 per ton for MEGALAC and/or rebate $200 per ton for ESSENTIOM purchases January 1, 2019 through December 31, 2019 for customers who are qualified and enrolled in the MEGALAC Step Up Program (see above for qualifications).

ARM & HAMMER will send reimbursement checks within 45 days of receiving Rebate Request Form and approved supplier invoices from the customer.

Producer E-Signature

Date (mm/dd/yy)

To qualify for the MEGALAC step up program, producers must meet the following criteria:

Thank You.