“Meet Me”/”Deals” Registration Form

Restaurant Contact

• Name of Restaurant/Business*
• Address*
  Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
• Business Phone Number*
• Website or Facebook Page
• Contact Name*
  First Last
• Contact Title*
• Contact Email*
• Contact Phone*
• Participation*
  Please select"MEET ME" Restaurant/Business"DEALS" Restaurant/Business
• Answer this ONLY if you selected "Meet Me" above.
  We prefer to provide our own gift cards.Please design a gift certificate for my approval.
• Specific Details of Discount*
• Gift Cards
  If you have opted to provide your own gifts cards, please state the date and time when we can pick up six $25 gift cards, for the first six months.. Your Meet Me status will be complete when gift cards are received. Thank you!
• Comment and/or Message
• Name
  This field is for validation purposes and should be left unchanged.