Interfaith Nexus Committee
Putting Faith in Business
Business Name
Business Primary Email
Business Start Date (Year Only)
Primary Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Owner Name 1
*
First Name
Last Name
Business Owner Name 2 (optional)
First Name
Last Name
Core Mission/Brief Description
*
Reason for starting business
*
Core values of business
*
Why is joining the Interfaith Nexus Committee important for your business?
*
Please answer the following question in detail.
Does your business offer discounts?
*
YES
NO
Do you attend a place of worship?
*
YES
NO
May Clergy members place a Interfaith certificate in your establishment?
*
YES
NO
Can your establishment seat/service 20 plus Clergy Members?
*
YES
NO
Please Select Month and Date for Interfaith Clergy Gatherings
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Primary Business Owner Signature
*
Please verify that you are human
*
Submit
Submit
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