Adv. Program Vendor Registration Form

Type of Product/Service

Group Rate

Exclusive Offer

Name of Business

Street Address/Location

City, Zip, State

Phone

Website

Contact Person (Name)

Please indicate who in your organization is authorized to offer this program or discount. Thank you.

Online Approval Name

Online Approval Email

Offer to VSEA members (for example: “15% discount on regularly-priced items; good throughout the year”)

Additional Information (other store locations, etc.)

Attach logo or other ad graphics here:

Upload a File

We welcome your questions regarding the program.

Email: Advantage@vsea.org
Phone: (802)223-5247
Fax: (802)223-4035