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On-line Application

Complete the following application to be approved for participation by the university. All fields marked by an asterisk (*) are required.

Or click here to download the pdf file. Fill out and mail to:
Christine Noon - RowanCard Program Coordinator
Bursar's Office
201 Mullica Hill Road
Glassboro, NJ 08028

Business Information
Name of Business*
Business Address*
City*
State*
Zip*
Website
Business Phone*
Business Fax*
Alcohol Sales*
Number of years in business*
Number of years at current location*
Corporate/Billing Information
Name*
Address*
City*
State*
Zip*
Phone*
Fax*
Tax Information
Federal Tax ID#*
Corporate Entity*
Name and Title of Person Signing Agreement
Name*
Title*
About the Business
What category fits your business*
If you are a restaurant, what type of food do you serve? (fast food, pizza, chinese, etc.)
Do you deliver*