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First name
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Last name
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Organization
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Email
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Phone
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Business Fax
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Name of business
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Address
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Business Website
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Business Phone
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Business Email
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In Business Since:
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Business Category
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Business Type
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Sole Proprieter
Partner
Corporation
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Principal products sold or service (s) rendered
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What separates your business from your competitors?
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Position and title held:
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Can you authorize, purchase, and sign the check for services (i.e. tires for company vehicle, etc.))
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Yes
No
Yes/with approval from higher authority
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Previous or additional occupation?
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Member of BBB
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No
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Member of Chamber of Commerce
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Yes
No
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Member of other organizations?
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Club Sponsor
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