Care, Share and Participate Service Provider Application

First Name

Last Name

Phone *

Email *

City

State

Name of business or organization

List type(s) of services or merchandise you sell or offer.

Will you agree to offer our Care, Share and Participate members at least a 10% discount off of your products and services

Yes

By signing this agreement, I commit to providing special discounts on my business's products and services to all Care, Share and participate cardholders who present their valid membership cards. In return for participating in this membership program, PTWWN Broadcasting will promote my business through complimentary advertising, which includes 40 commercial spots per month over a twelve-month period.

Yes I understand the cost to enroll as a Service Provider is a one time fee of $199.00

Membership - As a Care, Share and Participate Provider, you are eligible for free membership. Would you be interested in a complimentary membership.

Yes

As a Care and Share provider you are also eligible for exclusive television advertising opportunities on major TV Networks through our digital marketing service. This package includes 17,000 thirty-second commercial spots distributed across the following networks: ABC, CBS, NBC, CNN, BET Plus, OWN, Lifetime, Bravo, CW, Tubi, Pluto, Discovery, Bounce TV, TLC, HGTV, Oxygen, and MSNBC. These advertisements will air within my designated zip code area at a member rate of $3,250 for each thirty-day campaign period. I may choose to run these campaig

Yes I am interested in this offer. understand this Offer and will consider later

No I am not interested in this offer.

I accept the terms of this agreement

Clear

Today's Date

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.