BAF BlackList Sign-Up Form
Terms and conditions: This Directory is being provided as a convenience and service to BAF member businesses; it does not constitute an endorsement or an approval by the Black Achievement Fund of any of the products, services or opinions of the corporations, organizations, or individuals listed. The Black Achievement Fund reserves the right to remove any listing for any reason it deems necessary at any time.
Date
-
Month
-
Day
Year
Date Picker Icon
Name
*
First Name
Last Name
Are you a BAF member?
*
Yes
No
Business Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Is this for a Business or Nonprofit?
*
Business
Nonprofit
Is this business majority Black-owned?
*
Yes
No
Name of Business or Nonprofit
*
Name of Business Owner(s) or Nonprofit Executive Director
One sentence description of business/service or nonprofit
What discounts can you offer BAF members?
5% off programs/services
10% off programs/services
15% off programs/services
20% off programs/services
25% off programs/services
Other
Address of Business or Nonprofit
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website
Type NA if there is no website for the business
Facebook page
Type NA if there is no Facebook Page
Instagram page
Type NA if there is no Instagram Page
Youtube page
Type NA if there is no Youtube Page
Twitter page
Type NA if there is no Twitter Page
LinkedIn page
Type NA if there is no LinkedIn Page
Please upload Business logo in jpeg
Browse Files
Cancel
of
Submit Application
Should be Empty: