Use this form to sign up participating businesses.
Do NOT send this form to Result$ (keep it for your organization’s records).
Company Name: _______________________________________________________
The Offer: Check one of the following offers
(Check One)
____ Buy __________________ At Regular Price & Get ___________________ Free
____ 20% Off Any Purchase
____ 15% Off Any Purchase
____ 10% Off Any Purchase
____ OTHER – Print Your Offer EXACTLY As You Wish It To Appear (75 characters max.)
(Abbreviate
where possible • Do Not repeat stipulations that will
be printed on ALL cards — See Stipulations Below)
_______________________________________________________________________________
The Following Stipulations Will Be Printed On ALL $avings Cards:
Valid for
cardholder only • Offers may vary • Present card when ordering
Equal or lesser value always applies • Good only at participating locations
Not valid with other coupons, specials, sales or discounts
I agree to advertise on the $avings Card at NO COST to me or my company.
