Business Information Form printable pdf download

Business Information Form

List your Business on the Elkton Virginia Business Directory

Complete this form and return with at least one business photo (High Resolution,

JPG format preferred) to:

Elkton Virginia Town Hall

Attn: Kim Shifflett

173 W. Spotswood Avenue

Elkton, Virginia 22827

Business Name: ___________________________________________________

Owner / Manager Name : ___________________________________________

Business Address: _________________________________________________

City: _________________________ Zip Code: _________________________

Phone: ___________________________

E-mail Address: ___________________________________________________

Website Address: __________________________________________________

FACEBOOK URL: ___________________________________________________

Google+ URL: _____________________________________________________

Business Information & Description of what you provide customers:

Do you want to have a coupon with your listing?

______YES _____ NO

If yes, please provide the text for the coupon here:

__________________________________________________________________

Business Information Form