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HR Home >> Benefits >> Employee Discounts >> Vendor Information >> Registration Form

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Vendor Registration Form

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All submissions for discounts for products and services must include a publishable contact name and phone number. If a product or service discount is time sensitive (discount available for less than one calendar year), the product or service cannot compete with an existing product or service featured in the PERQS Discount Program Guide or available as a Duke University or Health System benefit.

Business Name:

Business Address: (including City, Zip Code)

Business Phone:

Contact Person Name:

Contact Person Phone:
(if different than above)

Email Contact:

Description of Discount:
(as you would like it to appear advertised including any restrictions associated with the offer)

 

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