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Expression of Interest Form

1. Name of Business

2. Business Listing Category

(as found in Yellow Pages)

3. Vendor Offer

Description of goods or services you are offering a discount or value increase on, including amount of discount/value-add and all limitations of the offer.
  • If groups of offer items fall under different discount categories (e.g. all bath items 25% discount vs all kitchen items are 2 for 1) please specify in separate boxes.
  • If your offer is complex and includes many different and interdependent details, please contact EPP@viha.ca to introduce your offer.
    For example, if your offer involves banking services that are based on fluctuating external rates.
Examples
  • Description: a. All items in the store, b. Cellular telephone service monthly plans
  • Discount offer/Value add: a. 25% discount on goods, b. Receipt of a model X cellular telephone with sign up for monthly plan B
  • Limitations of offer: a. Offer limited to regular price items only, b. Offer valid in X, Y, Z locations only

Description of Offer

Discount Offer/Value-add

Limitations of Offer

Description of Offer

Discount Offer/Value-add

Limitations of Offer

Description of Offer

Discount Offer/Value-add

Limitations of Offer

4. Applicable Business Location(s)

(i.e. address, phone number, and fax)

5. Are you a current member of the Better Business Bureau?

6. Business Website Address

for EPP administration research purposes only, not to be confused with publication content.

7. Contact Details of Main Business Office

mailing address, phone, fax, and e-mail

8. Key Contact Person


name, business title, and phone extension

9. General Comments

10. Signature

Before submitting this form you must create an online signature to verify the above information.

By typing your first and last name into this field you are verifying that the above information is truthful and accurate.