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Marjorie O'Neill MP's Local Business Email Sign-Up
Fill out this form to sign up to Marjorie O'Neill MP's local business email list, where we will be providing updates
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Name of Business
*
Your answer
First Name of Contact Person for Business
*
Your answer
Last Name of Contact Person for Business
*
Your answer
Email
*
Your answer
Phone number
Your answer
Address
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Local Business Website Page
If you would like to be added to the local business page of Marjorie O'Neill's website, where we advertise local businesses and the services that they provide, please fill out the information below. You can see the local businesses page here:
https://marjorieoneill.com.au/covid-19/local-businesses/
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Link to Website/Facebook Page/Instagram Page
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Type of Business (Cafe, Beautician, etc.)
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Type of Service
Take-away
Delivery
In-store
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