Black Business List: #MyBlackReceipt
We are partnering with organizations to provide lists of businesses to buy from in your city.  Please complete the form below if you want your list or your application listed.  Or, if you want your business added to our list on our list from June 19 - 26, 2021.  

Businesses submitted after June 19, 2021 at MIDNIGHT will be uploaded within the next 24 - 48 hours.

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In what country are you located? *
Your Company Name *
What does your company sell? *
Your Company Website  (include https://www)
Instagram Website (leave this blank if you do not have one)
Twitter Website (type NA if you don't have one)
How many social media followers do you have?
Company's City (if you are outside of U.S. type of your country) *
Company's State (please type two letters only) *
Company's Zipcode (if outside of US, type country code) *
Is your company a for profit or nonprofit *
Is your business Black-owned *
Your First and Last Name *
Your Email *
Your Phone Number (XXX-XXX-XXXX) *
What type of business is it? *
In what sector is your business? (for example: Education, Beauty, Hair, Techncial, Retail, Service, Restaurant, etc.) *
Do you have a Black business list? *
If you have a list of Black-owned busineses, link it below....
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