BBB Accredited Business Application

(items in red below are required)


Business Name  (please list names in order of best known to the public)
Business name #1:
Business name #2:
Business name #3:
 
Business Address
Address: 
City:
State:
Zip:
Mall:
 
Mailing Address Check here if same as above
Address:
City: 
State:
Zip:
 
Contact
Public phone:
Private phone:   (for BBB use only)
Fax:
  Fax anytime
  Fax during the day only
  Do not fax to me
Web address: 
Public email:
 
 
Please list three principals of the business (Mr./Ms. First, MI Last)
Primary Contact:
Title:
Email:
 
Additional:
Title:
Email:
 
Additional:
Title:
Email:
 
Complaint Handler:
Title:
Email:
Fax:
Complaints Should Be?: Mailed
Faxed
Emailed
 
 
Business Information
Number of employees:
Established:   
Incorporated:   
Type of business entity: Corporation
Partnership
Sole Proprietorship
Franchisee
LTD
LLC
Headquarter City:
Headquarter State:
Is company a franchise? Yes No
If yes, where is franchise headquartered?
Do you have service/delivery
van(s)/truck(s)?		 Yes No
   
  Click on entry box to select
from Type of Business Listing   

Type of Business:

Additional type of business #2:

Additional type of business #3:
Additional type of business #4:
Additional type of business #5:
Additional type of business #6:
   
   
  Licensing Information
Please list license number, type, issuing agency
Please specify if it is a personal or company license.
 
   
  Brief factual description of products and/or services

 
   
  Additional locations
Please list address, city, state, zip code
and if at a mall the mall name
   
  Additional public telephone number(s)
   
  Service Area
Examples: USA, State, City, Town, County, North Shore
   
  Why did you decide to apply
for BBB Accreditation?

 
 
Have you been recently contacted by a BBB Representative? Yes No
 
Email a copy of this Application to: