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2. Please complete this form if you would like to offer a discount to New Hanover County Government employees.
4. Business Name*
5. Business Phone*
6. Business Website
8. Business Address*

   Including City, State, and Zip Code

10. Contact Person Name*
11. Contact Person Phone

    If different than above, will not be published

12. Contact Person Email*

    Will not be published.

    
    

14. Description of Discount*

    As you would like it to appear advertised, including any restrictions associated with the offer.

16. This submission is...*
    -- Select One --a new discount offera change to a current offer
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field