Uniball Sample

*Indicates Required Field

Please complete the form below to receive your free uni-ball Jetstream™ 101 pen.

Name*:

Mailing Address*:

City*:

State*:

Zip*:

Click here to receive special offers and updates.

Company Name*:

Job Title*:

Account Number*:

Email*:

No purchase is necessary for this offer. You must be age 18 years or older to participate.

Complete and electronically transmit a request form at www.freejs101.com (the "Website") between January 1, 2011 and December 31, 2011 (the "Promotional Period") to receive a free Uni-ball sample by mail, while supplies last.

Incomplete requests will not be honored or acknowledged. Sponsor reserves the right to substitute the pen with an alternate pen of equal or greater value if featured pen becomes unavailable (subject to announcement on the Web Site). Please allow 3-6 weeks for the shipment following receipt, verification and processing of request. Limit one (1) request per person and per email address during the Promotional Period. Additional requests will not be honored. No PO Boxes allowed, a street or rural route address must be provided. Fraudulent submissions could result in prosecution. Sponsor is not responsible for electronic transmissions or mail that are lost, late, misdirected, damaged, postage due, undeliverable, garbled, destroyed or otherwise not received by sponsor for any reason. No substitutions allowed. Void where prohibited, taxed or otherwise restricted by law.

Sponsored by Newell Rubbermaid Office Products, Oak Brook, IL 60523.