The Gift Corporation 100 Main Street, Suite D Hempstead, NY  11550 516.483.3300 Fax: 516.483.3313 Email: admin@thegiftsociety.org
Name of Business	* required
Website
Address1	* required
Address2
City	* required
State	* required
ZIP	* required
Country (other than US)
Telephone	* required
Fax
Email	* required
Type of Business:(   )DBA (   )Partnership (   )Corporation
Link to our website?	Yes No
Please describe Discounts, Premiums, Services, Gifts, Coupons or other Gratuities:
Level of Participation: (  )Level Two .... $5000           (   )Level One .... $1000	Yes No
Please make Check payable to THE GIFT CORPORATION.                            I understand that my company is responsible for making, developing and maintaining my own website. I promise to join the The Gift Society and obey all rules and regulations appertaining to same.

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