Discount Request Form

If you are military personnel, a teacher, first responder, or truck driver, you qualify to apply for an exclusive 10% discount as our heartfelt thank you for your dedication and service. Complete the form below to verify your eligibility and claim your special savings! The 10% discount can be applied toward monthly payments or as a one-time discount when paying in full.

Basic Information

Full Name *

Phone *

Email *

Occupation *

Verification Details

Employer/Organization Name *

Job Title: *

Employment Verification Document (ID Badge, Pay Stub, Employment Letter)

How long have you been in this profession?

Reva Nation Product requested:

Payment Option Requested

I certify that the information provided is accurate, and I am an active employee in the selected profession.
I understand that this discount is subject to verification and may be revoked if the information provided is false.
I agree to receive updates, special promotions, and news via email and texts. You may opt out at any time by replying STOP.