To be considered for inclusion in the Employee Discount Program, please complete the following: Company Name * Contact Person * Address * We require a brick and mortar address to appear on each website that participates in our program. Phone * (Ex. xxx-xxx-xxxx) We require a phone number to appear on each website that participates in our program. Website Address (URL) * Company Email * We require an email contact to appear on each website that participates in our program. Promotion Code Enter your promo code here if you have one you would like to use. Discount Category * - Select -Air and Water TreatmentApparelAutomotive / MotorcycleBabyCar RentalsCommunications / Cell phones / Satellite DishesComputers / Software / AccessoriesCoupons / Discount PortalsEducationalEntertainment / Music / BooksFitness / SportsFlowers / Plants / GiftsFood / RestaurantsHealth / Beauty / MedicalHolidayHome Furnishings / Home Improvement / Home ServicesJewelry and AccessoriesLinensLodgingMiscellaneousMoving / StorageOffice SuppliesPetsRetailSecurityServicesSports MemorabiliaTheme ParksTravel / Transportation Type of Discount Offered Describe the type of discount(s) or service(s) to be given to all full or part-time University of Iowa faculty and staff who are eligible for benefits (not temporary or student employees.) For example, 10% discount on all tires. Agreement We agree to continue this offer until we advise the University of Iowa we no longer want to participate in the program. The university reserves the right to discontinue participation in the Employee Discount Program at its sole discretion.