Girlfriends List Application

Girlfriends Business List Application

Complete the form below to be added to the Girlfriend's List.
Business Name: *
Contact Name: *

First Name Last Name
Title:
Business Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Website:
E-mail: *
Contact Phone: *

Area Code Phone Number
Social Media: *

Facebook Instagram
Twitter LinkedIn
How did you hear about us?: *
If referred by a member please provide her name.
Business Category: *

Business Services Home, Auto & Events Beauty, Fashion & Lifestyle
3 Business Referrals - Name & Number. Past clients only *
If an LOG VIG refers you, your business will be certified.
Affiliate / Membership Organizations : *
Memberships, Boards, Business Organizations, Social Organizations
Why are you joining the Girlfriends Lis? *
Upload your Logo or picture. *

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My Products

Limited Time Special Fee $ 99.00

Total $ 0.00

Girlfriends Business List Application