2022 Restaurant Week Registration Restaurant Name* Restaurant Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Restaurant Logo* Drop files here or Select files Max. file size: 256 MB. Contact Person* First Last Phone*Email* RW Categories - Please select one or more categories for your eatery!* Morning Munches Lunch Dinner Sweet Treats RW Buy-in Levels (select one)*Full Service ($50 + $100 Gift Card)Quick Serve ($50 + $75 Gift Card)Coffee/Bakery/etc. ($50 + $50 Gift Card)Total Due $0.00 payment method credit card Credit CardCard Details Cardholder Name By submitting this form, I agree to have a gift card submitted to Downtown GJ no later than Monday, March 28, 2022.* I agree Any additional comments or questions?