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APEGA Member Benefits
Partner Application Form
Contact Information
Company Name
*
Website
*
Mailing Address
*
Contact Name
*
First Name
*
Last Name
*
Contact Position
*
Contact Email
*
Contact Phone
*
Please provide a brief description of your company
*
Proposed Benefit
Category of Benefit Provided
*
Automotive
Clothing
Education
Electronics
Entertainment
Financial Management
Health and Wellness
Insurance
Legal Services
Travel
Other
Please type in your category type
What is the discount/benefit that you are offering to our members?
*
Please provide a detailed description of the proposed service and benefit for our membership.
*
How is the proposed service better than what the public can receive?
*
Are you offering a percentage or "finders fee" to APEGA?
*
Yes
No
What percentage/fee are you able to offer to APEGA?
*
Who can redeem the benefit?
*
APEGA Members
APEGA Staff
APEGA Friends & Family
Please select all that apply
Are you able to distinguish between APEGA Members and APEGA Staff using your product/service?
Is identification required to redeem the benefit?
*
Yes
No
What location(s) does your service cover?
*
Edmonton
Calgary
Red Deer
Ft. McMurray
Grande Prairie
Lethbridge
Medicine Hat
Cold Lake
Edson/Hinton
Lloydminster
Nationwide
Please check all that apply
Is your service/product available online?
*
Yes
No
Is an app available for your service/product?
*
Yes
No
Administration
APEGA requires metrics from our Providers on a quarterly basis. Please select which metrics you are able to provide.
*
Number of Users
Sales Total
Total Savings
Number of Inquiries
Other
Please select all that apply
Please state which other metric(s) you are able to provide
Are you partnered with any other Association(s)?
*
Yes
No
Who are you partnered with?
Are you able to provide promotional material for your service/product?
*
Yes
No
What promotional material are you able to provide?
Are you able to provide information/educational sessions for your service/product?
*
Yes
No
What are your expectations of APEGA?
*
Please note that access to our membership database/member information is strictly prohibited
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