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2. Business/Company Name:*
4. Address 1:
   (This is the location
   address in the Village,
   not a corporate address)*
6. City 1:*
8. Zip 1:*
10. Address, City, State, Zip 2:
    (This can be a corporate
    location or mailing address)
12. Proposed/Current Use
    or Type of Business
    (i.e. grocery store,
    restaurant, gas station
    etc.)*
14. Number of Full Time Employees:*
16. Number of Part Time Employees:*
18. Number of Seasonal Employees:
    (if applicable)
20. Square Footage of Building/Space:*
22. Owner/Manager Contact Name:*
24. Company/Contact Phone Number:*
26. Company Fax Number:
28. Company/Contact Email:
    *
30. Company Website:
32. Month & Year Business
    Started Occupying Building:*
34. Own or Lease:*

    1. Own
    2. Lease
36. Can the Village list your contact information in the online business directory?*

    1. Yes
    2. No
    3. Name & Address Only
38. If there is additional
    information you would
    like to submit please
    do so here:
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print

* indicates a required field