Pre-Tenancy Application Form
Property Desired:
*
Kiosk $100/mo
Store $150/mo
Food Court Space $125/mo
Premium Store $200/mo
Book Store $50/mo
Music Store $50/mo
Art Gallery $50/mo
Music Artist ONLY (Not producers selling beats). Provide the direct link to 1 song for preview:
Are you applying for a Food Court Space?
*
YES
NO
Food Court Applicants Must Use A Delivery Service. Please List All Delivery Services You Use:
UberEats
PostMates
Door Dash
GrubHub
Caviar
Other
Please provide the direct links to your page for each Delivery App:
Business Name:
*
Please List Your Business Website:
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What Industry Is Your Business In?
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Please Select
Beauty
Health
Fitness
Clothing
Shoes
Toys
Automotive
Computers & Electronics
Home & Garden
Travel
Other
Please add 5 - 10 Keywords to help people locate your business
*
If you have a Welcome Video that will appear when people visit your store please provide a YouTube or Vimeo link - if Youtube, be sure the video is NOT listed as "FOR" kids or it can't be shared. If you don't have a video now, don't worry, if you are approved you'll be able to provide a link between the 15th-22nd and anytime after your Store/Kiosk is active in The Black Virtual Mall.
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Applicant Personal Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number. You will be notified via SMS of your application status.
Email
*
example@example.com
Job Position/Title:
Applicant's Signature
Clear
Date Signed
-
Month
-
Day
Year
Date
Submit
Should be Empty: