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BBB Accreditation Application

Your Business:	Allied Integrated Marketing [ Change this Selection ]
Your Business ID:	193

Business Name: (required)

Doing Business As (DBA):

I wish to provide more BUSINESS NAMES.

Business Address: (required)

City:

State:

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Zip:

Store Number:

Check all that apply: Home BasedMain OfficeBranch OfficeeCommerceMall Location

Hours of Operation: Click here to enter the Hours of Operation for your business.

Mailing Address is the same as the Location Address

Mailing Address: (required)

City:

State:

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Zip:

Corporate HQ City/State:

I wish to provide additional ADDRESS information.

Business Phone: (required)

Business Fax:

Private Phone: (BBB Internal Use Only)

Cell Phone:

I am interested in receiving text messages from BBB at the cell phone number(s) provided - Standard text messaging rates apply.

I wish to provide additional PHONE/FAX information.

Principal Contact:

Salutation:

First Name:

MI:

Last Name:

Suffix:

Title:

Email:

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Fax:

Cell:

Contact this person about any complaints against this business.

Secondary Contact:

Salutation:

First Name:

MI:

Last Name:

Suffix:

Title:

Email:

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Phone:

Ext:

Fax:

Cell:

Contact this person about any complaints against this business.

I wish to provide additional CONTACT PERSON information.

Web Site Address (URL):

I wish to provide additional WEB ADDRESSES.

Public Email:

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Request a Quote Email:

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Sales Email:

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Customer Service Email:

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Tech Support Email:

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When BBB sends information - such as requests from potential customers - our preferred method of contact is:

Licensing Required? YesNo

Licensing Number:

Agency:

Issued:

Expiration:

I wish to provide additional LICENSING information.

Employer Identification Number (EIN):

When and Where did the Business Open: (required)

Date:

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State:

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Incorporated:

Date:

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State:

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Type of Business Entity: (required)

Local Business Start Date:

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# of Employees: (required)

Additional Notes/Details to BBB:

Your Name: (required)

Your Title: (required)

Your Email: (required)

You may email me about my BBB Accreditation application.

Business agrees to commit to BBB Accreditation Standards and agrees to the following:

Business agrees to comply with BBB Accreditation Standards
Business agrees to respond promptly and fairly to any complaints, if received.

I certify that all the information provided in this BBB Accreditation application is true and accurate to the best of my knowledge & I am authorized to submit this information on behalf of the business.