AllergyBites Discount Card Application Form

AllergyBites Discount Card Application Form

Please provide all requested details below.
Your business
Business Name*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Website*
Facebook URL
(if applicable)
Twitter URL
(if applicable)
Instagram URL
(if applicable)
Your discount

Describe the discount (or other promotion) you are offering cardholders. Note that a discount should be available to cardholders year-round. (Exceptions are made for special circumstances. Please explain under "Restrictions.")
Discount*
Restriction(s)
(if applicable)
Promo Code
(for online businesses only)
About your business

Please describe your business in 50-100 words. Note: The listing you provide is what will appear on the AllergyBites promotional page.
Your listing*
Your logo

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Contact information

This information will not be shared publicly.
Contact Name*
Contact Phone Number*

Area CodePhone Number
Contact Email*
example@example.com
Should be Empty: