Directory Application

Owner Name: (Person making the pledge)

Business Name, Address, City, State, Zip

Email Address

Phone

Company Website

Social Media Info / User Name

Business Category (Check all that apply) Business Category (Check all that apply) Agriculture Animal Care Arts/Entertainment Automotive Business Services Child Services Commercial Contracts Construction Employment Engineering Environmental Financial Food & Beverage Government Contracts Health/Medical Home/Lawn Insurance Internet Legal Manufacturing Nonprofit Personal Care Printing/Graphics Real Estate Security/Safety Technology Telecommunications Training/Education Transportation Travel Other

If "Other," please specify

Specialization

Other Services

Licensed? Licensed? Yes No

Insured? Insured? Yes No

Veterans Discount Veterans Discount Yes No

If Yes, please explain the discounts you offer.

Are you a veteran? Are you a veteran? Yes No

If Yes; What Branch of Service?

Enrolled in E-Verify? Enrolled in E-Verify? Yes No

*Do you pledge to honor the U. S. Constitution and immigration laws? In addition, will you try to reach U.S.Veterans, Military Dependents and First Responders on employment opportunities? *Do you pledge to honor the U. S. Constitution and immigration laws? In addition, will you try to reach U.S.Veterans, Military Dependents and First Responders on employment opportunities? Yes No

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