Group Dining Application

To apply, please complete and submit this application. If you have any questions, please click here to contact Group Dining.

1Personal Information

First Name: *

Last Name: *

Full Name of Organization: *

Type of Organization: *

Address: *

Phone *

Email Address *

How did you hear about the program? *

Is your organization Tax Exempt? *

Upload your group's Tax Exempt Certificate: *

PDF Files Only.
You must upload a copy of your Certificate Letter.

Upload your group's W9: *

PDF Files Only.
You must upload a copy of your W9.

Accounting Contact: *

Accounting Email: *

Accounting Phone: *

Accounting Fax: *

2Card Recipients

Please list staff members(s) who should receive Group Dining card(s).

Recipient 1 *

Name: *

Title: *

Add more staff members

3Terms & Conditions

I agree to the following Terms & Conditions: I acknowledge that by submitting this application my organization understands and agrees to determine whether any purchases charged to our account were in fact authorized by me or our approved card holder. We understand and agree that a valid Group Dining ID card must be shown at the time of purchase. We also understand and agree that we are responsible for payment on all such purchases made on our account whether or not those purchases are made by our approved users.

You must accept the Terms and Conditions to submit your application.

Whataburger

Group Dining Application

Recipient 1 *