Fillable STAR Application Form2010 10 20

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STAR Application Form2010 10 20

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Business Name ___________________________________________
Contact Name ___________________________________________
Email Address ___________________________________________
Phone Number _______________ Fax Number ________________
Primary Business Address _________________________________
Please list any other participating business addresses.
________________________________________________________
________________________________________________________
________________________________________________________
Business Website Address __________________________________
Discount Details ______________________________________________
________________________________________________________
________________________________________________________
How is this discount greater than discounts offered to the general public?
________________________________________________________
________________________________________________________
By signing this application, you agree to all conditions set forth in this appli-
cation and the STAR policy. This application shall not be viewed or used as
a contract.
__________________________________________ ____________
Signature of Business Owner or Authorized Agent Date
__________________________________________
Printed Name
Please return completed STAR Application form to:
STAR Program; PO Box 940; Covington, LA 70434 or fax to 985.898.6415.
STAR Application
If you have any questions about the STAR Program or need assistance
with the application, please contact the STAR Program at 985.898.3297
or star@stpsb.org.
STAR Application 6.3.10:Layout 1 6/7/2010 8:56 AM Page 1
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STAR Application Form2010 10 20

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Completed 20 July 2020

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