Merchant Contract Form | UAMS Partners Card

Merchant Contract

Restaurant/Merchant Name * Required
Phone * Required
Contact Person * Required
First Last
Email * Required
Fax Number
Address * Required
Street Address Address Line 2 City State ZIP Code
If you have multiple locations. Add those below.
Website/Social Media
This contract confirms our participation in the Partners Card fundraising program to benefit Winthrop P. Rockefeller Cancer Institute Auxiliary, an Arkansas non-profit organization. We agree to offer a 20% discount excluding alcohol.

The following conditions apply:

- The Partners Card entitles shoppers to a 20% discount during the 10-day shopping period from October 30 - November 8, ONLY. The Partners Card is non-transferable.
- We agree to advise all restaurant/merchant personnel of this agreement, and to promote the purchase of the Partners Card.
- We acknowledge that the Cancer Institute Auxiliary retains all proceeds from the sale of the Card.
- The Cancer Institute Auxiliary assumes no liability in connection with Partners Card or otherwise.
- We are not required to honor the Partners Card 20% discount on already reduced “sale” merchandise.
- All store merchandise is to be discounted 20% for Partners Card holders unless otherwise noted on the contract.
- Compliance with these conditions is required for continued participation in Partners Card.

EXCLUSIONS, IF ANY, MUST BE NOTED ON THIS CONTRACT/Application.
Restaurant/Merchant name (as you wish it to appear in the Directory):
Fifteen word description of the restaurant/business, noting exclusions, if any: It will be printed in the cardholders’ information that alcohol and tip are excluded from the discount. UAMS Partners Card has the right to change or correct a description for printing purposes.
Please indicate below if the description will remain the same as last year.
Description * Required
We would like to sell the Partners Card at our location: * Required
- Yes
- No
- Management and sales personnel agree to promote the purchase of the card. - We understand that the Partners Card is to be issued only to individuals (not families or companies). - We agree to make the Card available for purchase in our store(s) from October 8 through November 8. - We agree to control validated cards and the funds received from card sales until collection.
If you have questions, call Susan Jones (501) 686-8286 or email jonessusank@uams.edu or shhenry@uams.edu
Partners Card Agreement accepted by:
First Last