Join Dine 4 Less Online

Join Dine 4 Less Online

Following completion of this form, a representative from iHeartMedia will be in touch with you to set up specific dates for your promotion.
Name of Restaurant *
Your Name (if not manager) *

First Name Last Name
Name of Manager

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Website URL
Menu URL
Upload restaurant logo & secondary images of restaurant (5 max)

Browse Files

Cancel of
Tell us about your restaurant
Can certificate be used to purchase alcohol?
Can certificate be used at other locations?
Cash back for unused portion?
Use more than one certificate at once?
Full face value must be used at one time?
Agreement Terms:

I agree to provide 130 $50 gift certificates to iHeartMedia to participate in Dine 4 Less
Certificate Terms:

I will supply iHeartMedia with printed gift certificates OR I would like gift certificates to be Print on Demand*
* Print on Demand: allows purchaser to print directly from their home printer instead of receiving their certificate in the mail.

Questions about Dine 4 Less Online? Please contact Kelsey Schmitz at kelseyschmitz@iheartmedia.com
Additional comments
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