Sea Devil Discount Club Application

Note: only businesses located in the greater Wilmington area qualify at this time.

Company Name:*
Contact Person:*
Title:
Business Address:*
Street Address City State Zip Code
Phone:*
Email:*
Website:
Type of Discount:*
Amount of Discount:*
Do you need a window decal?
- Yes
- No
Comments:
Comments

This field is for validation purposes and should be left unchanged.

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