Business Directory Application

Is the business within a 30-minute drive from Crofton, MD?(Required)

This is currently only a local directory for Crofton area businesses.

Yes

No

Business Location(Required)

This directory is only for local businesses. Please enter the city, state, and ZIP code for your business. If you do not have a fixed location where customers can visit, please use the location where you work from or where the business is registered.

City State ZIP Code

How is your business affirming of the LGBTQ+ community?(Required)

Please check all that apply. Affirming businesses should be able to check all of them.

We seek to create an affirming environment for customers and all community members

We provide a positive and affirming workplace where LGBTQ+ employees can work with dignity and without stigma. If we do not currently have employees, we will do this when/if we have them.

We demonstrate ongoing LGBTQ+ community engagement throughout the year, and not just in June

We will listen to and be receptive of any feedback we receive from LGBTQ+ communities regarding any perceived or alleged instances of discrimination, bullying, hate, or the like

How are you related to the business?(Required)

You must be the owner or an authorized representative of the business to apply for the directory. If you are neither of those, please send the link to someone who is authorized to apply for the directory.

Owner

Authorized representative

Contact Info

Please only complete this form if you are the owner or an authorized representative of the business. This information will not be shared in the directory and will be used to verify the business information for inclusion in the directory.

Your Name(Required)

First Last

Your Email(Required)

Your Phone Number

Owner's Name(Required)

First Last

Owner's Email(Required)

Owner's Phone Number

Business Info

This information will be displayed in the directory.

Business Name(Required)

Business Description(Required)

Please include a description of your business.

How does your business affirm and/or support the LGBTQ+ community?(Required)

We know we already asked this, but we’d like to hear it in your own words and get some more details.

Please explain why you were unable to check all of the boxes that listed how your business is affirming.(Required)

We would like more details about why your business does not do one or more of the following:
We seek to create an affirming environment for customers and all community members
We provide a positive and affirming workplace where LGBTQ+ employees can work with dignity and without stigma. If we do not currently have employees, we will do this when/if we have them
We demonstrate ongoing LGBTQ+ community engagement throughout the year, and not just in June
We will listen to and be receptive of any feedback we receive from LGBTQ+ communities regarding any perceived or alleged instances of discrimination, bullying, hate, or the like

Business Website(Required)

Business Email(Required)

Business Phone Number

Business Address

If you want people to come to your location, please include the address. Don’t fill this out if your business doesn’t have a fixed location where customers can visit.

Street Address Address Line 2 City State ZIP Code

If you do not have a business address, please explain how people can work with you

Business Ownership

Please check all that apply to the majority ownership of the business

LGBTQ+

Woman

BIPOC

Disability

Veteran

Business Instagram