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AHI BIPOC Business Form
African Heritage, Inc. is creating a BIPOC owned business database in Northeast, Wisconsin. We would like you to complete this form to the best of your ability. If you have any questions, please email
ljones@africanheritageinc.org
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* Indicates required question
Email
*
Your email
Business Name
*
Your answer
Business Owner First & Last Name
*
Your answer
Type of service you provide
*
Restaurant
Beauty (Nails, Hair, Lashes, Make up, etc.)
Auto Repair
Art
Clothing
Other:
Business Address
*
Your answer
City
Your answer
Phone Number
*
Your answer
Business Social Media Links
*
Your answer
Business Owner Race/Ethnicity
Your answer
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