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2. Business Name*
3. Proprietor*
5. Address1*
7. Address2
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Fax Number*
16. Business Logo
    Please send as a png or jpeg file
18. Type of Business*

    1. Retail
    2. Services
    3. Dining

    1. Arts
    2. Entertainment
    3. Health and Wellness

    1. Industry
    2. Lodging / Accommodations
20. Photos for Website Regarding Business
    Please send as jpeg or png file
21. Photos for Website Regarding Business
    Please send as jpeg or png file
23. Information Regarding Business for Website*
    1-2 paragraphs, if possible, detailing information regarding your business
25. Name of Person Entering Information*
27. Phone Number*
28. Email Address*
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field