Retailer Sign Up Store InformationLocal Store Name (as it will appear in printed materials) * RequiredLocal Store Address (as it will appear in printed materials) * Required Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Website - enter a valid website URL for example https://www.google.com * Required Local Store Phone Number * RequiredLocal Contact Name/ Title * RequiredLocal Contact Email * Required Business Listing DescriptionPlease provide below a maximum 20-word description of store merchandise, noting exclusions, as it should be listed in the Shop With Heart Card. The Heart Guild/The Shop With Heart Card reserves the right to edit final wording. Description * RequiredIf you would like to use the same description as last year, please type "last year"ExclusionsBusiness Category Listing * RequiredAntiquesArt, Framing, & PhotographyBaby & MaternityBaggage & Travel AccessoriesBeauty & SpaBooks, Cards, Stationary, & GiftsChildren's Fashions & ToysEntertainmentFloral, Garden, & OutdoorHome Furnishings & DecorJewelry & Jewelry ServicesMen's Fashions, Shoes, & AccessoriesMen's & Women's Fashions, Shoes, & AccessoriesPersonal & Professional Services & ProductsPet Products & ServicesRestaurants & Specialty FoodsSpecialty Retail & GiftsSporting Goods, Health & FitnessWomen's Fashions, Shoes, & AccessoriesPlease designate your store category for listing purposes Shopping Area * Required1960 Area/ Champions Vintage ParkBay Area/ PearlandBellaire/ Meyerland AreaCentral Houston/ Montrose AreaCITYCENTREThe Galleria MallThe Galleria AreaHeights Area/ Washington AveHighland VillageHighland Village AreaKaty Area/ FulshearKingwood/ North HoustonMemorial/ West HoustonNorthwest Houston/ CypressPost Oak/ San FelipeRive Village/ West UniversityRiver Oaks Area/ Upper KirbyRiver Oaks DistrictRiver Oaks Shopping CenterSugar Land/ Fort Bend CountyTanglewood/ Briargrove AreaTown & CountryUptown ParkWestheimer/ Fountain ViewThe Woodlands Market StreetThe Woodlands/ Montgomery CountyWoodway/ VossPlease list the shopping area below that best describes where your business is located. (Each store will be listed under 1 location) Sell Shop With Heart CardsWe ask that each store consider the SKU Card Sales process as it secures that funds are collected when the purchaser receives the card and benefits and a seamless transition transaction at the end of the event. Please select the sales process you prefer to use for processing Card sales. Please select the sales process you prefer to use for processing Card sales * Required SKU* Card Sales Process: Participant agrees to set-up a Non-Merchandise SKU to process Card sales. This process will ensure that sensitive customer information is secure and will provide an efficient way to manage Card sales. QR Code Sales Process: Participant agrees to direct their customers to purchase the Shop With Heart Card by using the QR code that is printed on the marketing materials, or by visiting the shophouston.heart.org website. Upon completion of their payment, they can elect to either use the card on their phone or Participant can give them a booklet. Terms and Conditions * Required I agree This agreement confirms our participation in the 2024 Shop With Heart Card fundraising event and acknowledges our agreement to the terms and conditions stated below: • We acknowledge that AHA retains all proceeds from the sale of the card. • We are financially responsible for all cards sold, missing, lost or stolen cards. Each card has a cash value of $75. All unused Cards must be returned to the American Heart Association no later than May 31, 2023. • We agree to sell and promote the Shop With Heart Card during the 10-day fundraising event from Friday, April 19 through Sunday, April 28, 2024. Including displaying materials provided: posters, brochures, and other marketing items. • We will not accept credit cards or checks from Card purchasers outside of the USA - Cash only. • We understand the Shop With Heart Card is non-transferable and we will request photo identification to ensure only the person whose name and signature appears on the Card, is using the Card. • We agree to advise all store personnel of these conditions and to promote the sale of Cards. • We agree to not run a store-wide promotional discount on regular priced merchandise where the discount competes with the Shop With Heart Card discount during the 10-day fundraising event. • We will honor the 20% discount on all regular priced store merchandise for Shop With Heart Card holders unless merchant is under a contractual agreement that prohibits such discount on specific merchandise. • We are not required to honor the Shop With Heart Card 20% discount on: sale merchandise; gift certificates/cards; layaway payments; online purchases; previously purchased merchandise; special orders; restricted merchandise. Card is not valid with any other offer. • We have noted all exclusions, if any, on the front of this Shop With Heart Card Participation Agreement. • We will not replace lost or stolen Shop With Heart Cards, and we understand the American Heart Association and Heart Guild of Houston will not replace lost or stolen Cards.
