Merchant Account Discount Form
For all practical purpose, the FloraPages Online Floral Community is a FREE website. The only requirement in becoming a Merchant Member is to extend a discount of your choice to our FloraPage Community Customers. The higher the discount, the higher your Merchant Ranking on the FloraPages Online Floral Community. In other words, the higher discount receives a greater visibility and better promotion than a low discount. It behooves the the merchant to give as much discount as he or she can because it will help the local florist and the merchant will have gained access to a BRAND NEW market.

( = required information )


Business Name:
Owner's Name:
Business Address:
City,State,Zip:
Business phone:
Home phone:
Cell phone:
Fax Machine:
Email:
Web Site URL:
What type of floral
business are you in?
If Other:
Who referred you to the
FloraPages Network?
If Other:
What discount percentage are you
offering to FloraPage Customers:
If Over 60%:
Are you the owner of this
business ( company )?		 Yes No
How Long in Business?

Please provide a list of your major products and/or services.

Please add any comments that you wish.

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