Perk Vendor Application Form

General Information
Are you currently an FIU Employee?

Are you currently an FIU Employee? Yes (Please contact Office of University Compliance & Integrity at compliance@fiu.edu regarding the Outside Activity/Conflict of Interest disclosure requirements) No
Please provide the information below
Company Name:
Company Address:
Company Phone Company Phone - ### - ### ####
Company Email:
Company Website:
Company Social Media Profile Links:
Main Contact Person
Name:
Email:
Phone: Phone: - ### - ### ####
Perks/Services/Discounts Offered

Perk/discount offer must be unique or greater than discount(s) offered to the general public. Final decisions, approvals, and/or rejections are at the sole discretion of Florida International University.
What specific services/perks are you offering to the FIU community?
If there is a discount involved, what is the discount amount/percentage?
Please provide the unique promotional code. Please list how to redeem this discount (i.e., present a valid FIU card at checkout, promotional code, visit our website for details on receiving your discount, etc.)
Please illustrate the process to redeem the offer.
Is the promotional code stackable?

Is the promotional code stackable? Yes No
Does the promotional code apply to all the services/merchandise offered?

Does the promotional code apply to all the services/merchandise offered? Yes No
If the promotional code has restrictions, please provide us with applicable terms and conditions.
Is the promotional code redeemable in-store or online?

Is the promotional code redeemable in-store or online? In Store Online Both
Is the offer available at all locations?

Is the offer available at all locations? Yes No
If the offer is availible only at specific locations, please provide a list of the authorized locations.
If insurance-related, does the discount work with our insurance plans for the State of Florida employees?

If insurance-related, does the discount work with our insurance plans for the State of Florida employees? No N/A If yes, please specify the plan/s. If yes, please specify the plan/s.
Is the perk/service/discount that you are offering:

Is the perk/service/discount that you are offering: Limited time Offer/Seasonal (valid for less than one year) Permanent
Company & Perk Description/Summary
Please provide a brief description of your organization and summary of the perk offered as you would prefer it to appear on the website. Note this wording will be posted on Employee Perks and Service website.
Maximum of 500 characters allowed. Currently Entered: 0 characters.
Attachments
Please attach a promotional flyer including the unique discount code/service offered, instructions on how to redeem it, and other relevant information (e.g., offer detail, business address, contact information).

Attach Files

Perk Vendor Application Form

Perk Vendor Application Form

General Information

Please provide the information below

Main Contact Person

Perks/Services/Discounts Offered

Company & Perk Description/Summary

Attachments