V5.1
Merchant Agreement
Date
Physical Address
Merchant Name (Doing Business As)
Phone
Merchant Address
City
Corporate Address
Merchant #
For O ce Use Only
Fax State
ZIP
Check if same as above
Merchant Corporate Name
Primary Phone
Merchant Address
City
Secondary Phone State
ZIP
Primary Email Address (Required for proof) Re-sign
Proof Requested (Email required)
Email Logo/Photo (Email must be received within 7 days of date on contract)
Logo/Photo Attached
SA Designs Logo
Schedule ‘A’ Attached
Discount Details & Internet and Wireless Program Indicate: FD/CD/FF/Rec /Ent/Ret/Svc
# FINE DINING, CASUAL DINING, FAST FOOD, RECREATION, ENTERTAINMENT, RETAIL & SERVICES SECTION and your guest are cordially invited to enjoy One Complimentary Lunch or Dinner Entree of your choice with the 1 You purchase of a Lunch or Dinner Entree of equal or greater value.
$
2 Enjoy a FREE Menu Item of your choice with the purchase of a Menu Item of equal or greater value.
$
3 Enjoy 50% OFF a/ n (
$
4 Enjoy a FREE (____________________________
_) of your choice with the purchase of a Maximum Up To Value
Admission: Enjoy One FREE Admission with
5 the purchase of an Admission of equal or REC
$
greater value. Golf: Enjoy a Free Greens Fee with the 6 purchase of a Greens Fee of equal or greater $ value.
No. Of Coupons
Bowling: Enjoy Three FREE Games
7 for the Second Person when the
SVC
8
$
10
Other:__________________________________________________________________________________________________
$
11
Other:__________________________________________________________________________________________________
$
12
Other:__________________________________________________________________________________________________
$
20% OFF Total Purchase
No. Of Coupons
$
Other:__________________________________________________________________________________________________
15% OFF Total Purchase
Maximum Up To Value
First Person pays for Three Games. Dry Cleaning: Enjoy 25% OFF the regular price of Any Dry Cleaning $ Order.
9
More Internet & Wireless Program O ers:
No. Of Coupons
$
Indicate
REC
Maximum Up To Value
25% OFF Total Purchase
% OFF Total Purchase
Discount O er: Card Program: Additional Information and Special Instructions (hours valid, disclaimers, etc.). Note which o er(s) this information and/or instruction(s) apply to:
This o er is NOT valid with any other discounts, coupons, specials or on holidays. One coupon per person, per visit. SaveAround coupons are not transferable. The undersigned has reviewed the above o er(s), and does hereby agree to allow SA to include the above o er(s) in its Discount Program, and also understands and agrees to the terms and conditions of this Merchant Agreement set forth on the reverse side hereof. The undersigned represents that he/she has the authority to execute this Merchant Agreement on behalf of the Merchant named above.
Authorized Signature
SaveAround Signature
Print Name
Print Name
Position
Phone
(Do NOT abbreviate)
Ext.