The Book Vendor Information Form FY26

The Book – Vendor Coupon Information
Contact Name*

First NameLast Name
Contact Email*
example@example.com
Contact Number*
Please enter a valid phone number.
Business Name*
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Number*
Please enter a valid phone number.
Business Website*
Meals Eligible: (check all that apply)*

BreakfastBrunchLunchDinnerAll of the aboveN/A
Notes:
Days of the week to include:*

SundayMondayTuesdayWednesdayThursdayFridaySaturdayAll of the above
Hours to include:
Standard Promotion: (choose one)*

RESTAURANT: 1 free entrée when entrée of equal or greater value is purchasedTHEATRE: 1 free ticket when ticket of equal or greater value is purchasedWINERY/BREWERY: 2 tastings at half the regular price
Standard Gratuity*

20% gratuity will be added to total bill before discountOtherN/A
If other than Standard Gratuity:
Standard Exclusions: UVA Graduation Weekend, New Year’s Eve/Day, Valentine’s Day, Easter, Mother’s Day, Father’sDay, Thanksgiving, Christmas Eve/Day
Additional exclusions or notes: (eg. No takeout/Dine-in only/No Restaurant Week)
Logo: Please upload your logo *

JPEG or PNG file / Logo will print in Black & White
Cancelof
If you need help with this form or have questions, please contact Ophelia Lenz, Development Officer, at 434-972-3568 or ophelia.lenz@hopva.org.
Should be Empty:

The Book – Vendor Coupon Information