Small Black Business Directory Form

Dubuque Black Small Business Directory

Service provided by the BIPOC Leader & Professional Collective
Is Your Business in Dubuque. Foreign companies are not accepted if not licensed in the state of Iowa

Yes No No, but Iowa Base
Business or dba Name *
Primary Contact Name *
Primary Phone Number *

Area Code Phone Number
Secondary Number

Area Code Phone Number
Business Address (MUST INCLUDE IF PHYSICAL LOCATION) Online business skip to next section

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Website
Email address to be used in listings *
Person Completing this form
Best email address to be used for us to contact you
Person Completing this form - Phone Number

Area Code Phone Number
Business Description *
Briefly describe the products/services you offer. *
List hours of operation *
What geographic areas does your agency serve?
Social Media Links
Are you searchable on Google? *
Year Agency Opened *
Which of the following best describes the services your agency provides (choose up to 5) *

Accounting Administrative Arts & Culture Beauty Care/Service Clothing Store/Boutique Community Services Community Resources Consulting Services Construction Consumer & Small Business Services Criminal Justice & Legal Services Day Care - Adult Day Care - Child Deaf/Blind Services Designer (Non-Manufactured) Disabilities - Adult Disabilities - Children Education/Mentor Programs & Resources-Adult Education Programs & Resources-Child Emergency Services Employment - Adult Employment - Youth Energy Assistance Food Service (Restaurants, Catering, Food Truck) General Assistance Health Care Home Health Care Homeless Shelters Hospice Services Housing Assistance Information Technology Life Coaching (Personal Development) Makeup Artist Medical Services Mental Health Services Adult Mental Health Services Children/Youth Multi-Level Marketing Music Services (Engineer/Audio House) Notary Painting Personal Assistant Personal Trainer/Personal & Professional Development Pregnancy Assistance Prevention Education Services Religious Ministries Self-Help Groups Substance Abuse Services Adult Substance Abuse Services Youth Transportation
If your customer/client is searching for your company online, what key words or tags would they use? (ex. body care-type each tag and hit enter after each)
Please verify that you are human *
*This directory is informational purposes only. We advise all consumers and potential clients to do their own due dilegence of potential service providers, retail and privately owned stores. The business list is not an endorsement from the "Collective" Small Businness Alliance of Dubuque nor Tri-Phoenix Group, LLC (and affiliates). All business that are included on the listing are responsible for their own compliance according to local, state and federal laws.
Listing is free but donations are welcome!

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Credit Card Number	Security Code
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Dubuque Black Small Business Directory