Full Name
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Email Address
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Phone Number
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Preferred Contact Method
Email
Phone
Text
Business/Nonprofit Name
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Business Type
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Sole Proprietorship
LLC
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Partnership
Nonprofit
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EIN Number
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Is Your Business Black-Owned?
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Yes
No
Is Your Business Veteran-Owned?
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Yes
No
Branch of Service
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Army
Air Force
Coast Guard
Marines
Navy
Space Force
Business or Nonprofit Description
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Business/Nonprofit Website
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Social Media Channels
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Primary Industry
*
Retail
E-commerce
Nonprofit
Healthcare
Fitness
IT
Fashion
Media
Food & Beverage
Other
Who Is Your Target Audience?
How Did You Hear About The Black Vet?
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Social Media
Website
Referral
Event
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Other
Additional Information
Terms & Agreement
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