BUSINESS AGREEMENT Business Name Phone Street Address Suburb Website (optional) Listing Proposed exclusive discount or value-added offer (maximum 46 characters including spaces) DETAILS Other Territory outlets where your offer is available to Seniors Cardholders Directory Street Address BUSINESS Free First Name Surname Position Postal Address DETAILS E-mail ABN only use Mobile Phone Fax Office CONTACT I agree to extend this offer to seniors visiting the Territory (please indicate below). Interstate Seniors Card holders International Seniors I have read and agree to the terms and conditions listed and I am authorised to enter this agreement. / / AUTHORISATION Signature of applicant Date Position SENIORS CARD BUSINESS AGREEMENT NT Seniors Card is administered by the Northern Territory Government. The business provider:
BUSINESS AGREEMENT Business Name Phone BUSINESS DETAILS Free Directory Listing Street Address Suburb Website (optional) Proposed exclusive discount or value-added offer (maximum 46 characters including spaces) Other Territory outlets where your offer is available to Seniors Cardholders Street Address CONTACT DETAILS Office use only First Name Surname Position Postal Address E-mail ABN Mobile Phone Fax AUTHORISATION I agree to extend this offer to seniors visiting the Territory (please indicate below). Interstate Seniors Card holders International Seniors I have read and agree to the terms and conditions listed and I am authorised to enter this agreement. / / Signature of applicant Date Position SENIORS CARD BUSINESS AGREEMENT NT Seniors Card is administered by the Northern Territory Government. The business provider:
seniors-card-business-registration-form.docx