moveBuddha Certified Program Application

moveBuddha Certified Program Application

This is the initial application for the moveBuddha Certified program. After submission, we will review your information and follow up with you directly for additional information.
Your Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Role
What is your job at the company?
Business Information
Company Name
Business Entity Name
Previous Entity Names
The names of any previous business entities under which your company has operated
Year Founded
Brand Type
Franchise Brand Name
Business Email
example@example.com
Location Information
How many locations do you have?
Location Address 1

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Location Address 2

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Location Address 3

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Location Address 4

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Location Address 5

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Licensure
Just leave these fields blank if they are not applicable.
USDOT Number
MC Number
State License Number
Online Profile
Website URL
Google Business Profile URL
Yelp URL
BBB URL
Facebook URL
Instagram URL
Fleet
Number of Trucks
Services
Specialty Services
Do you offer your storage services through a third party?
Name of the third party
Address of the storage facility

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Service Type
How do you determine your service area?

Other
Should be Empty:

moveBuddha Certified Program Application

Your Information

Business Information

Location Information

Licensure

Online Profile

Fleet

Services