Member - Minority – Central Illinois Business Directory – Minority Business Development Center

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category: *

Employees:

Full-time Part-time

Business Keywords (enter a space between words): *

Comments / Questions:

License #:

List Certifications Earned:

List Degrees Earned:

Are you Bonded?:

Years in Business?:

Other memberships::

MBE/WBE/DBE certified?:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Social Networking:

LinkedIn Facebook

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

MBDC Directory Member: $0.00
Directory member ONLY DUE TO COVID-19, ALL FEES ARE WAIVED UNTIL DECEMBER 31, 2020. BBA member Level 1: $120.00
Basic membership BBA member Level 2: $276.00
Basic membership and includes radio air time and discounts BBA member Corporate Level: $500.00
Basic Corporate membership for up to 5 employees. BBA member Corporate PLUS Level: $676.00
Includes Radio air time and discounts for up to 5 employees.

Additional Opportunities:

We will contact you with additional information.

MBDC Directory Member w/BBA membership : $0.00
Directory membership is HALF OFF if you are also joining the Black Business Alliance (BBA). DUE TO COVID-19, ALL FEES ARE WAIVED THROUGH DECEMBER 31, 2020.

Payment Option:

Bill me Charge my credit or debit card

BUSINESS DIRECTORY

Member Application

Mailing Address

Address

Address