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1. Your Name (Required.)

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2. Business Name (Required.)

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3. Business Address and proper contact name, phone and email address for this initiative so we can confirm participation (Required.)

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4. Product or service discounted - please explain percentage off or other offer and any stipulations you require

(i.e. Mainstyle Flooring 10% Off; Discount covers flooring materials. Must show military ID at time of sale. Terms: 50% down at time of sale and balance due upon completion of installation.) (Required.)

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5. Anything else you want to tell us about this offer. You can see an example of another BBB's list here: http://bit.ly/NbA3Di

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6. Thank you so much for your participation!!

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