Business Name
*
Owner/Operator Full Name
*
First Name
Last Name
Operating Location Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
Note from the Owner (To Be Displayed On Our Website to Visitors)
*
Who you are, how covid-19 is impacting business and how you're battling, etc.
What dollar amounts do you have available for Gift Cards or Certificates?
*
$5
$10
$20
$25
Any
Other
Would you be willing to share about this promotion on your social media channels?
Yes
Maybe
No
Do you agree to allow us (Cards For Covid) to use your image/brand on our website to sell your gift cards, which we will purchase from you and ship to the buyer?
*
Submit
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