LBI (Local Business Information)

Business Information
Company Name*
Address:*
Street Address City State / Province / Region ZIP / Postal Code Country
Address 2: (IF)
Street Address City State / Province / Region ZIP / Postal Code Country
Phone:*
Fax: (IF)
Toll Free Number: (IF)
Website:*

please type in with https:// (you can copy and paste it from here)
Profile Email / Web Mail / Business Email: (IF)
Business Type / Category:*
Products / Services:*
Products / Services:*

Video URL (Try to give 5 Videos): (IF) url
Additional Information
Tag Line / Business Slogan: (IF)
Specialties (exclusive products, areas of expertise): (IF)
Cities Served / Counties Served / Areas Served: (IF)
Language Spoken: (IF)
Wi-Fi: (IF)
Parking Available (Yes/No): (IF)
- Yes
- No
Reviews: (IF)
Testimonials: (IF)
Coupons & Specials [Get more business by adding an offer or discount. You can update or delete your coupon at any time]: (IF)
Offers [like this - 20% off all haircuts, Expires: Oct 15, 2013]: (IF)
Brand Names Carried: (IF)
Affiliations (BBB Member, Sites / Trade License#, chamber of commerce etc...): (IF)
Please post here all Social Media Page URLs (Facebook, Twitter, Printerest, LinkedIn, Blog...): (IF)

Owner Information
Name*
First Last
Position / Job Title:*
Owner / Contact Person Gender:*
- Male
- Female
Owner / Contact Person Date of Birth: (IF)*
Date Format: MM slash DD slash YYYY
Owner / Contact Person Bio: (IF)
Owner / Contact Person Location: (IF)
Street Address City State / Province / Region ZIP / Postal Code Country
Owner / Contact Person Photo: (IF)
Wordpress Login info: username/password*
Google Business login and url:*
Domain email account for US: please setup an email acct @you domain.com for us to use. (e.g. lokal@yourdomain.com)*
Name
This field is for validation purposes and should be left unchanged.

Business Information