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Business Name*

Details of the promotion you are offering*

Days your business is participating*

Check all that apply.

Friday, September 9th

Saturday, September 10th

Sunday, September 11th

Other

Street Address*

Please provide the physical addresses of the location participating.

Do you have more than one location?*

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Will you be giving from your web orders?

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Information for Promotion

Please attach your logo or image you would like to be included in marketing materials.

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Facebook profile

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Instagram username/handle

Website link

Your Name*

Or the best contact person regarding Shop & Dine United

Phone Number*

Your Email*

Any Additional Comments

How did you hear about Shop & Dine United?

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