Membership Application Please complete our form to activate your Purchasing Power Plus Retail Membership and join our community of Healthcare Gift Shops: Primary Contact Person (Include First and Last Name)* Title* Secondary Contact Person (Include First and Last Name) Title Primary Contact Phone #* Secondary Contact Phone # Primary Email Address* Secondary Email Address Corporate Name (Hospital, Pharmacy, Facility…)* Bed Size (When Applicable) Gift Shop Name* Mailing Address* City* State* Zip* Gift Shop Phone Ship to Address is the same as the Mailing Address Different Ship to Address City State Zip We’d love to know how you found your way to the PPP Retail Community—or who we may thank for connecting us. Membership Terms (Please Read & Initial Below) Your PPP Retail Membership is valid for 12 months. Fees are nonrefundable and not prorated, unless canceled by PPP. Renewals are not automatic, but you can easily renew online or by mail each year. We provide a savings tracker so you can keep up with your discounts throughout the year—PPP does not collect or monitor this data. Each Gift Shop receiving shipments must have its own active membership. Discounts may only be used at eligible locations that match the Corporate Name, Gift Shop Name, Bill To, and Ship To addresses we have on file. If you’re a third-party operator managing multiple locations, this fee schedule doesn’t apply—please reach out and we’ll walk you through your options. You’re always free to choose the offer that works best for you, but please note that PPP discounts can’t be combined with other promotions, and regular exclusions still apply. By joining, you agree that PPP may share your contact information (including email) with our partners and markets so they can keep you informed about their products and services. By typing your initials and name below, you confirm your agreement to these terms. This serves as your digital signature.* I have read and agree to all Terms of Service Agreement. Type Initials for Agreement* https://purchasingpowerplus.com/memberterms/ Membership Application Signature of Agreement (Typing your name is equivalent to a digital signature for the purposes of this document.)* Date* MM slash DD slash YYYY Comments This field is for validation purposes and should be left unchanged.
