Local Email Coupons by Better-Values

Tell us below where you would like to receive coupons and specials via email from and if they sign up with us, we'll send you $150!

Enter as many places as you want. Tell your favorite stores owner or manager about us to better your chances to receive $150. No obligation or contracts... just CASH in your pocket. Easy Money!

Tell Us About Yourself

Full Name:		Date of Birth:
Email Address:
Mailing Address:

City:	State:	Postal Code:

Who do you want to receive coupons in your inbox from?

Store Name:	Type Of Business:

Contact Name (Managesr or Owners Only):

Address:

*
City:	State:	Zip:

Store Phone Number:	Store Fax Number:
	*
Additional Phone Number:	Web Site Address" (if applicable)
*	*
Contact E-mail Address:
*
Additional Comments or Instructions:
*
NOTE: Please make sure all the information above is correct. We need to be able to contact both you and the store in which you are suggesting to get them to sign up. Only if the store signs up will you receive $150.