Saving Money by richman6

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									            Motivano SmartSavings Merchant Referral Form
Please complete form and return to referrals@motivano.com
                                                            Merchant Responses
Client Name

Merchant Name


Local Merchant or National Merchant



Location(s) (please indicate all locations)

Type of Product


Brief Description of Your Company (255
character including spaces)


Discount Offer (Must be entered for
processing)


Discount Offer redeemed by way of? (ex:
submit Client id or coupon)


Expiration Date



Contact Info (Please included name,
address, phone and email)

Website



Prior relationship with this client? (Y/N) If
yes, please send agreement form pertaining
to this.



Are you interested in offering the promotion
to all Motivano clients? (if not enter client
name)



Additional information

								
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