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#VerifiedBlackOwned Business Sign Up Form
Buying products from #VerifiedBlackOwnedBusinesses is a direct way to keep our dollars circulating in Black community and build Black collective wealth. Around 41% of Black-owned businesses have shuttered due to the COVID-19 pandemic. It’s important now more than ever that we support Black entrepreneurship and make sure these remaining businesses survive and thrive! We have to redouble our commitment to #BuyBlack. This form serves to connect Black owned businesses within the areas of Los Angles, South Bend, Long Beach, and to our campaign! BUSINESS OWNERS/Main Management are to fill out the form below in its entirety. You will be notified of your approval of your application within 5 days of completing the form. If you have any questions please email:
Owner(s) Name *
Phone Number *
Email *
Business Name and Description of Products/Service *
Category *
Business Address (Street, City, State, Zip Code) *
How many people do you employ? *
How many of your employees are Black? *
Social Media Handles (Instagram, Facebook) *
Which statement(s) best describe your business? *
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