Business Name:
Business Address:
Business Category:
Business Phone Number: Please include area code.

Hours of Operation:
Business E-mail:
Business Website:
Text to Display:
Business Contact:
Business Title:
Business Discount:
Please specify the percentage or amount of discount. Please include limits or conditions, if applicable. Example:"10% discount on parts and service."
Discount Start Date:
  • Month
  • Day
  • Year
Signature/Sign Off:
I agree to offer the above list discount to all veterans who provide the Victoria County Discount Card."

Neither Victoria County nor the Victoria County Clerk's Office shall be responsible for the content or accuracy of the merchant participation form, nor any event that may occur during the interactions between the veterans and a participating merchant.

If any questions, please contact the Victoria County Clerk's Office at (361) 575-1478 or Fax (361)575-6276 or via email at

Please share this with other merchants that may wish to participate in this program.