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Sand Dollars Application Form
Contact Information
Company Name
First Name
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Last Name
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Address (Street, City, State, Zip)
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Email Address
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Phone
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Business Information
Year Business Started
Eg. 2004
Please list all the persons that own 20% or more of the business:
Eg. Bob Smith, John Smith, etc.
What is your organization's primary business activity at this location?
Retail
Manufacturing and Process Industries (Non-Computer)
Construction/Architecture/Engineering
Online Retailer
Data Processing Services
Internet Service Provider or Application Service Provider
Wholesale/Retail/Distribution
Communications Center
Education
Aerospace
Food Establishment
Marketing/Advertising/Entertaining
Banking/Finance/Accounting
Research/Development Lab
Insurance/Real Estate/Legal
Business Services/Consulting
Federal Government (Including Military)
Computer Manufacturer (Hardware, Software, Peripherals)
State/Local Government
Computer/Network Services/Consultant
Medical/Dental/Healthcare
Computer Related Retailer/Wholesaler/Distributor
Transportation/Utilities
Other
If you checked other, please describe:
Please provide a brief description of your business and the product/service of the business:
Form of business
Sole Proprietorship
Partnership
Incorporation
LLC
Not Incorporated at this time
Other
If you checked other, please describe:
Other Information
How did you first learn about the program?
Referral
Social Media
Direct Email
Marketing Event
Newspaper or Magazine
Search Engine
Company Website
By submitting this form, you agree that all of the above information is complete and true to the best of your knowledge
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