GiftAMeal Sign Up Form - LA Fires Relief

To assist in the recovery from the Los Angeles wildfires, GiftAMeal is providing the following:

1) In January, GiftAMeal is doubling donations for all Los Angeles-area restaurants to provide extra help for wildfire victims.

2) Los Angeles-area restaurants that sign up in January get ONE MONTH FREE.

*Offer limited to the first 100 restaurants, 1 location per restaurant brand.

How many locations are you signing up? (Maximum 5 for Online Sign-Up) *

If you wish to sign up more than 5 locations, please click HERE

Start Date * +

Restaurant Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Restaurant Name (2) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Restaurant Name (3) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Restaurant Name (4) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Restaurant Name (5) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Features:

○ Donations Paid by GiftAMeal

+1 Meal per Photo

+1 Meal per Social Media Share

+50 Bonus Meals per Month

○ On-Premise and Off-Premise Photos

○ Dashboard Reporting

○ Royalty-Free License to Use Customer Photos

For either monthly or annual pricing options, your restaurant's first month will be free as stated at the top of this form.

Subscription Type *

Month-to-Month (No Commitment)

Annual (2 Months Free!)

Monthly Plan: *

GiftAMeal Provides Materials - $79/month

Restaurant Prints Materials- $69/month

Annual Plan: *

GiftAMeal Provides Materials - $790/year (Save $158!)

Restaurant Prints Materials - $690/year (Save $138!)

Subscription Type *

Month-to-Month (10% discount)

Annual (25% discount)

Monthly Plan: *

GiftAMeal Provides Materials - $71/month per location

Restaurant Prints Materials - $62/month per location

Annual Plan: *

GiftAMeal Provides Materials - $711/year per location (Save $237!)

Restaurant Prints Materials - $621/year per location (Save $207!)

First Name *

Last Name *

Title *

Individual's Phone Number *

Email Address *

Payment Options *

Bank Account (ACH Collection)

Credit Card

Credit Card

Cardholder Name (as it appears on the credit card) *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

CVV Code *

Billing Address:

Street Address *

Address Line 2

City *

State *

Zip Code *

Authorize Credit Card Payments *

Restaurant elects to make payments via pre-authorized credit card charges.

ACH Collection

Business Name (as it appears on the account) *

Account Type *

Checking

Saving

Personal or Business *

Personal

Business

Bank Name *

Bank Transit Routing Number - ACH (9 digits) *

Bank Account Number *

Authorize ACH Collection *

Restaurant elects to make payments via pre-authorized automatic clearinghouse (“ACH”) debits.

GiftAMeal’s Terms and Services Agreement

Terms *

Restaurant agrees to GiftAMeal’s Terms and Services Agreement, which are attached hereto and incorporated herein by this reference.

Signature *

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Email: info@giftameal.com | Phone: 314.656.6244