Member - Member Page – Black Business Alliance

Welcome to the Minority Business Directory of Central Illinois (MBDci). Our goal is to get YOU more exposure for YOUR business. The MBDci is hosted by the Black Business Alliance Peoria Chapter, Inc., where we help keep your business in the black, because the only color we see is green!!

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

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

Password: *

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

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. MBDC Directory Member: $50.00
Directory member ONLY

Additional Opportunities:

We will contact you with additional information.

MBDC Directory Member w/BBA membership : $25.00
Directory membership is HALF OFF if you are also joining the Black Business Alliance (BBA)

Payment Option:

Bill me Charge my credit or debit card

Print Application

Member Application

Mailing Address

Address

Address