Voucher Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Contact Information - Step 1 of 3Contact Name *Contact Phone *Contact Email *Job Position *Contact Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextBusiness Name *Business Phone *Business Email *Business Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNext Please use the images below as a reference guide as you create your passport voucher. Create Voucher Business Logo (JPG or PNG) (A in diagram) * Click or drag a file to this area to upload. Voucher Title (B in diagram) *Description *Is a reservation required? (F in diagram)YesURL or Phone number customers should use to make the reservationVoucher Value (e.g. Single Person Ticket) *Retail Value (USD) (G in diagram) *URL (More Info) (D in diagram)Voucher Image (JPG or PNG) (C in diagram) * Click or drag a file to this area to upload. Background Color or Image (JPG or PNG) (E in diagram) Click or drag a file to this area to upload. Voucher Terms (optional)Google Tracking Code (optional)Third Party Integration Code (optional)Social Media Links (optional)Valid Locations (D in diagram) *Would you like to be an affiliate seller and receive 30% of each passport sold at your venue? We will create a unique QR Code for you to use in marketing materials. This gives you the ability to upsell any ticket to a UV Passport! *YesNo - Please just list my venue on the passport.I have read and hereby agree to this site's Terms & Conditions and Privacy Policy (see link below) *I AgreeAgreement By signing below, I hereby state and agree that I have full authority from the business described above to make this decision on its behalf, and that all the submitted information is complete, accurate and free from illegal content. I give Local Passport LLC permission to use this content and information in their marketing platform and for marketing purposes. I agree that this voucher will grant full access to the offer described to passport holders, without any further payment, including sales tax, perpetually until cancelled. Once posted, any notice of cancellation must be given at least one month in advance before going into effect. I also agree that I have read the Terms & Conditions and the Privacy Policy (see below), and that I hereby agree to these terms in full. Finally, I agree that my name, typed below, will have the same legal weight and affect as my hand-written signature. *SignatureSubmission DateSubmit
