EmailMe Form - Restaurant Sign-Up Form

Restaurant Information

Did someone refer you, if so what is their name?

Restaurant Name: *

Restaurant Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Restaurant Phone #1: *

### - ### - ####

Restaurant Phone #2:

### - ### - ####

Restaurant Fax #:

### - ### - ####

Restaurant Email Address: *

Do you currently have delivery? *

Yes

No

If Yes, who handles the deliveries?

Owner Information

Owner Name: *

First Last

Owner Phone: *

### - ### - ####

Owner Email Address: *

Best Means of Contacting Owner: *

Manager Information

Store Manager Name: *

First Last

Store Manager Contact #: *

### - ### - ####

Store Manager Email:

Contacts:

Who to Contact for Operations?

Owner

Store Manager

Other

Who to Contact for Financial?

Owner

Store Manager

Other

Who to Contact for Business Development?

Owner

Store Manager

Other

Restaurant Hours & Closings

Monday Hours *

Tuesday Hours *

Wednesday Hours *

Thursday Hours *

Friday Hours *

Saturday Hours *

Sunday Hours *

Closed Holidays? *

Marketing and other information:

This information greatly helps with order growth, we can use your web addresses in association with our advertisements.

Web Site

Facebook

Twitter

Marketing Methods

Price

$ Dollars . Cents

Menu Upload

Upload a .PDF verison of your menu.

Are there any items not listed on the menu?

Dressing, sauces, extra options and etc

Direct Deposit

In order to deposit funds into your account we will need a copy of a voided check. Please take a picture or scan a voided check and attach below.

Upload a image of your voided check.

Date: *

MM / DD / YYYY

Service Agreement

Please read and agree to our Service Agreement.

*

I Agree

Print Name *

First Last