BlackDollar LLC Business Intake Form
Hello there! Thank you for your interest in listing your business with BlalckDollar's directory on our app. By simply filling out this form, we will list the name, location (if applicable), and website of your business on our app for free.
First and Last Name
Name of Business
What is your affiliation with this business?
Family or friend of owner/manager
Is this business Black-owned?
Business Phone number
Personal Phone Number
Please include a link to the most direct website for potential customers to access your information or services. If you do not have a website, please include a link to a page that showcases your information, such as a Yelp, Facebook, or Instagram link.
If your business primarily conducts its services primarily in person, please include the full address of each location from which you operate. If you are including multiple locations for businesses of the same name, please separate addresses by semi-colon [;]. If you are an online business, please include the major city or region you operate from.
How do you primarily distribute your services?
Type of Business
Accounting and Tax Services
Arts Culture and Entertainment
Auto Sales and Services
Banking and Finance
Beauty and Personal Care
Community Organization and Services
Dentistry and Orthodontics
Grocery and Convenience Shopping
Health and Wellness
Lodging and Travel
Marketing and Advertising
News and Media
Restaurants and Catering
Food Trucks or Catering
Shopping and Retail
Sports and Recreation
If you selected "Other," please specify your business category.
Business Instagram Handle
Business Twitter Handle
Business Facebook Page Link
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This form was created inside of BlackDollar LLC.