Black Owned Business Registration Form

Register Your Business

Please provide all required details to register your business with us.
Full Name*
E-mail*
example: yourname@email.com
Phone*
Business Name*
Business IG*
Please do not add the "@"
Website
Type of Business*
Service-Based Businesses*
Other
If we have not listed your business category, use this space to add it here.
Check all that apply

HandmadeEco-friendly/SustainableLGBTQIA+ ownedPlus-size options availableOther
Business Address
Select all that apply about your business location

Brick & MortarVirtual/MobileI also rent out my space for events.Other
If you'd like to refer other Black-owned businesses, add their info here.
Separate by comas
Message/Note
Totally optional.
By checking this box, you certify that the business in this form is a Black-owned business. By definition, this means at least 51% of the ownership of this company is owned by a Black person. *
Should be Empty:

Register Your Business