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2. Date*
   Date
4. Business Information
6. Name of Business*
8. Business Classification*
   -- Select One --AccommodationsIndustrialCommunity OrganizationsGeneral Services & RepairEducationHealth & BeautyPlace of WorshipProfessional ServicesSports & RecreationRestaurants/BarsShopping & Retail
10. Business Location*
    Civic Address or Legal Land Description
12. Business Phone Number*
14. Business Email Address*
16. Business Website URL
18. Facebook URL
20. Twitter URL
22. Instagram URL
24. Business Description*

    Description of service/product your business provides

26. Consent to Disclose Business Information*

    I give the Town of Slave Lake permission to place any of the above information on the website business directory and to release any of the above information in response to general public inquiry for specific services. By checking the “I agree” box below, you acknowledge and agree that 1) your submission will not be signed in the sense of a traditional paper document, and 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.

    1. I agree.
28. Electronic Signature*
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field