Apply For Coupon Verification Program

Your Name*

First Last

Contact Name*

First Last

Corporate Email Email*

Please make sure you've provided us an email address registered with a company domain (applications that only provide email addresses from services such as Gmail or Yahoo will not be accepted).

Title*

Company Name*

Company Address*

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

Company Website*

Are you an individual or representative of a company?*

Individual
Representative

How many unique coupons do you typically distribute per month?*

What coupon rules would you like to see implemented?*

Single Use
Location Restrictions
Removed/Disabled after Expiration Date
Non-sharable or Discoverable
Custom Redemption Screen

Check all that apply

Have you issued a copyright takedown notice on SnipSnap?*

Yes
No

Please electronically sign this notice by typing your full name here:

Signature*