Bama Perks Vendor Form – Human Resources

Important: Please review the Bama Perks Guidelines before completing this form

Business Name *

Business Address *

Country

City

State

Zip code

Business Phone *

Business Website Address *

Business Email *

Name/Position of Authorized Contact *

Authorized Contact Telephone Number *

Authorized Contact Email Address *

Offer Type *

Discount Offered *

Provide a brief description of your discount offer as you would like it to appear, including any restrictions and/or requirements: *

Please list how to redeem this discount (i.e., present valid ActCard at checkout, etc.): *

By submitting this form, you acknowledge that you have read the guidelines for participating in The University of Alabama Bama Perks Discount Program and agree to abide by them. You agree to notify the Benefits Office about discontinuation/changes to the discount or your involvement in the program, or if the relevant contact information changes by submitted an updated form online.

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