Business Promotions (COVID-19)

2. First Name*

3. Last Name*

5. Business Name*

6. Email Address

8. Business Address*

10. City

11. State

12. Zip Code

14. Business Phone Number*

15. Business Website

17. Business Hours*

19. How can patrons receive your services? (ex: phone or online only, curbside pickup, delivery, etc.)*

21. Tell us about any current promotions, offers, specials, etc. that you'd like us to promote

    If you do not have any specials currently going on, tell us what information you'd like us to promote (ex: online ordering, pickup and delivery options, new hours, etc.)

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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field