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.

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)

0 of 100 max characters

Information to be Updated/Added(Required)

0 of 200 max characters

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