Enroll

Enrolling in The Caregivers Marketplace is fast, confidential and free.

There are two ways to enroll, online or by mail. If you choose to use the form below to enroll online, you will reduce the processing time of your first Cash Back Check and minimize the possibility of data entry errors. Once you submit the online form below, you will immediately receive your Savings Number and an email welcoming you to the program which will contain all of the information you need to get started. If you prefer to enroll via regular mail, you can do so by completing and returning a Cash Back Request Form and submitting it with your first batch of receipts.

As a member of The Caregivers Marketplace, you'll have access to the following benefits:

  • Cash back for the purchase of eligible products
  • Our monthly e-newsletter, the Voice of the Caregiver®
  • Periodic updates to learn about new eligible products added to the program
  • Account details online and the ability to track the status of your Cash Back Checks – coming soon

All of your personal information will remain completely confidential and will never be shared with anyone else. To read our full privacy statement, please click here.

 
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General Information
First Name:  * Middle Initial:  Address 1:  *
Last Name:  *   Address 2: 
    City:  *
Email:  * State:  *
Verify Email Zip:  *
 
Gender: 
*
  Phone #: 
How did you find out about us?  *

Caregiving Situation
I am currently caring for someone with: (check all that apply)