Vendor Information
We appreciate your interest in partnering with AMIBA to share your service or goods with our affiliates and their member businesses. As the Localization Movement grows, so do the number of commercial ventures aiming to tap into it, so we rely on you providing this information to allow us to assess your company.

We are unlike most trade associations or other organizations that offer numerous services to members. Most of our affiliate groups use the talents, goods and services of their local business members where possible, but we do want to learn about potential sponsors or partners providing services not available from local businesses in most communities. Thank you. * = required field.

Company Name *
Your answer
Your Name *
Your answer
CityState / Province *
Your answer
Email *
Your answer
Website *
Your answer
Business Ownership *
Ownership notes *
Your answer
Product or Service *
Please explain what you're offering and relevance to AMIBA's mission or how it can serve our affiliates.
Your answer
How long has the company been in business? *
Please note any credentials or accomplishments
Your answer
Have you worked with other independent business advocacy groups? *
Please provide references if possible
Your answer
Why should a local business or Alliance work with your company rather than your competitors? *
Your answer
Is your product/service geared exclusively toward independent businesses /independent business coalitions exclusively or is it offered to any customer? *
Your answer
What is your familiarity with AMIBA or our affiliates? *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of AMIBA. Report Abuse - Terms of Service