JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Bushwick Daily Subscriber Program: Survey & Agreement
Everyone with a Bushwick Daily subscriber card will be able to redeem one discounted item or perk at participating businesses.
Email
alec@bushwickdaily.com
with any questions
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What's your name?
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
What is the name of your business?
*
Your answer
What's the address, including cross streets and neighborhood?
*
Your answer
What is your website, if applicable?
*
Your answer
What are your social media handles, if applicable?
*
Your answer
What makes your business so great? Tell us about your unique product selection or services that makes your business special!
*
Your answer
What benefit are you offering to Bushwick Daily Subscribers. (*discounted event tickets, one free drip coffee, half-off a sandwich, etc.*)
*
Your answer
Are there any restrictions on your benefit offer?
*
Choose
No
Yes
If yes, please specify.
Your answer
Do you have any questions or comments?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bushwick Daily.
Report Abuse
Forms
