Retail Alliance / LOVEVA Membership Application Form

I. ACCOUNT DETAILS

Business Name *

Date *

Website / URL *

Business Location Address (for public Member Directory)

Address Line 1

Address Line 2

City

State

Zip Code

If you do not have a storefront, please put in PO Box or leave blank

Mailing Address (if different to above)

Address Line 1

Address Line 2

City

State

Zip Code

Type of Business *

II. CONTACT DETAILS

Business Owner Name *

Owner's Direct Phone or Cell Phone *

Email *

Check relevant boxes for business owner

Primary Contact
Billing Contact
Marketing Contact
Click here if you wish to receive paperless communication

Manager Name

Direct Phone or Cell Phone

Email

Check relevant boxes for manager

Primary Contact
Billing Contact
Marketing Contact
Click here if you wish to receive paperless communication

Additional Contact Name

Direct Phone or Cell Phone

Email

Check relevant boxes for additional contact

Primary Contact
Billing Contact
Marketing Contact
Click here if you wish to receive paperless communication

III. LOVEVA PROGRAM ELIGIBILITY

If you wish to be part of LOVEVA, please click on the choices below that fit your business. If 3 or more choices are checked, please complete the LOVEVA details by clicking the link below this question. If less than 3 are checked, you are not qualified to join the LOVEVA program.

Are you a locally independently owned business?
Are decisions made locally as it relates to advertising, marketing, community engagement, charitable donations, purchasing, legal, etc?
Is the company headquartered locally in Hampton Roads?
Did the company originate in Hampton Roads?
Is the business privately held and not publicly traded?

**CLICK HERE TO COMPLETE THE LOVEVA DETAILS FORM.**

IV. MEMBERSHIP PRICING

Retail is defined as business to consumer; Retail Partner is defined as business to business. Details of inclusions for each level are outlined on our website at retailalliance.com. Please check the membership level you are interested in. *

Retail (1-5 Employees) $195
Retail (6+ Employees) $295
Retail Partners (1-5 Employees) $225
Retail Partners (6+ Employees) $325
Signature Partner $700
Co-op Partner $1,250
Co-op Tenant (enter Co-op Partner below) $145
LOVEVA* Branch Member (additional locations for LOVEVA app) $25 (enter quantity below)

If Co-Op Tenant checked above, please provide name of Co-Op Partner

If extra LOVEVA branches required, please mark quantity (above & beyond the original primary member location)

$ Total = (Membership Level Price) + (No. of LOVEVA Branches x $25)

Once this application form is received, an invoice will be emailed to you for payment. All memberships paid by credit card are automatically renewed annually with 30-day notice of charge prior to renewal. If you do not wish to auto renew membership, please check box below.

Checkboxes

Do not auto-renew

V. AGREEMENT

By completing the section below, you are agreeing to the Terms & Conditions in Section VI and that you have the authority to make decisions on behalf of the Organization outlined in the Application. You also agree to the LOVEVA merchant terms and conditions and privacy policy located online at bealocalloveva.com.

Name of authorized representative *

Title *

VI. RETAIL ALLIANCE & LOVEVA MEMBERSHIP TERMS & CONDITIONS

Click link below to refer to the terms and conditions of membership.

Click here for Terms & Conditions of Membership

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