Restaurants and Bars

Name of Participating Business (Public) (required)

Address of Participating Business (Public) (required)

City (Public) (required)

State (Public) (required)

ZIP (Public) (required)

Business Website (Public) (required)

Business Phone Number (Public) (required)

Business Facebook Link (Public)

Business Instagram Handle (Public)

Business Twitter Handle (Public)

Other Social Media #1 (Public)

Other Social Media #2 (Public)

Other Social Media #3 (Public)

Main Contact Name (Private) (required)

Main Contact Title (Private) (required)

Main Contact Email (Private)

Main Contact Direct Phone (Private)

Main Contact Direct Phone Extension

Public Relations/Social Media Contact Name (Private)

Public Relations/Social Media Contact Email (Private)

Public Relations/Social Media Contact Direct Phone (Private)

Public Relations/Social Media Contact Direct Extension

Does your business belong to a local hospitality group or other? (Private)
---YesNo

If Yes, Who? (Private)

Select How You Would Like To Assist
DiscountFree soda/H20/CoffeeFree appetizerFree dessertVIP entry/no cover chargeFree mocktailOther

If Other, Please Enter Here

Additional Notes