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.

Business Information:

* Business Name:

Business Address: (where offer is available)
(if applicable; if offer available at additional locations, please specify in 'Additional Notes')

City:

State:

Zip:

Web Address: (if specific to this disount)

Business Contact Information:

* First Name:

* Last Name:

Email:

Phone:

Discount Information:

* Offer Description: (e.g., 20% off all purchases)

* Offer Access Method: (i.e., coupon code SUNY)

* How would you like your offer to be listed: (Max 500 Characters)
(i.e., Juliana's Jewelry offers a wide variety of silver accessories and glass baubles. Members of the SUNY family receive a 20% discount when using the offer code "SUNY" at checkout.)

Offer Flyer/Attachment:

Offer Category:    Cellular Phone Service
   Computer & Office
   Health, Wellness & Beauty
   House & Home
   Pets & Garden
   Shopping, Apparel & Gifts
   Transportation & Automotive
   Travel, Leisure & Hobbies
   Other

Offer Available to:    Employees
   Students
   Faculty
   Retirees
   Alumni
   Affiliates (e.g., CUNY, RF)

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.

Your Privacy is Important To Us.

SUNY Benefits Discount Request Form