Rebate Program Application

Owner's name: *

Email: *

Restaurant Name: *

Group name:

Address: *

City: *

State: *

Zip: *

Main Phone: *

Cell Phone:

Fax:

Foodservice Distributors

Weekly distributor purchases:

Number of deliveries per week:

Primary Distributor

Name:

Branch:

Account number*:

Secondary Distributor

Name:

Branch:

Account number*:

Secondary Distributor

Name:

Branch:

Account number*:

* You will normally find the account number on the upper left or right side of your invoices.
Note: Please provide both account number and customer number if different.

I authorize Dining Alliance to collect rebates on my behalf to be distributed quarterly. I understand that Dining Alliance retains a portion of rebates earned for program administrative costs.

Initials: *

Latest News

Dining Alliance Enters the Dallas Hospitality Market, Offering its National Buying Power Advantage to Local Restaurant and Foodservice Operators
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Rebate Program Application

Foodservice Distributors

Cities

Latest News