SUNY Benefits Discount Request Form

  

Thank you for your interest in offering a discount to the SUNY network! In order for your offer to be reviewed, the below information is required. Once you have completed the fields, please click "submit". You may also provide this information using the document provided below.

Discount Request Form PDF pdf file

* Required Fields

Business Information:

Business Contact Information:

Discount Information:

Offer Category:     
    
    
    
    
    
    
    
    
Offer Available to:     
    
    
    
    
    
Additional Information:
* Verification:

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SUNY Discount Program Guidelines
Providers acknowledge and agree to abide by these guidelines upon completing and filing
a SUNY Discount Programs Request form with SUNY's Office of University Benefits.