BIPOC Directory Information Update Form

The purpose of the form is the allow the BIPOC community to update and/ or add businesses to the directory.

URL

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone Number

Business to Update(Required)

Business to Add(Required)

Your Relationship with the Business (ex. owner)(Required)

Information to be Updated/Added(Required)

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