Please use this form to submit your profile information to the Brandywine A-List. If you have any questions, please call us at 302/425-3939.

IMPORTANT: If you do not have time to complete this form in one sitting, we recommend that you type all of your information into a Microsoft Word document first, and save it each time you finish a section. This will allow you to copy/paste all your information into the online form once you have it all completed. We recommend this because, due to software limitations, you will not be able to save any one part of this form. You will only be able to submit the completed form, and any partial information will be lost.
OR… if you wish to submit your information via a checklist created in Microsoft Word, please email or call us and we will email the form to you. Let us know if you have any problems.


Business Type
Please choose what business category(s) you wish to be listed under. *Only choose categories that pertain directly to your business.
Category #1*
Category #2
Category #3


Basic Information
This information is for the Brandywine A-List's records. You will have an opportunity later in this form to submit the information you would like posted on your profile.
Biz Name*
Your Name*
Your Title*
Phone*
Cell Phone
Fax
Email*
Address*
City*
State*
Zip*
Web Address


Hours of Operation
All of these fields are required. If you are not open on any given day, please type "Closed".
Sunday*
Monday*
Tuesday*
Wednesday*
Thursday*
Friday*
Saturday*
By Appointment* Yes
No


Search Engine Keywords
Please submit up to 20 keywords that you would like to have associated with your profile on the Brandywine A-List. These words will give consumers another way to find you when they search the Brandywine A-List. For example, if you are a shoe store that also sell handbags, this would be a great place to put "handbags". Please separate each keyword with only one space.
Keywords*


Profile Information
The following information will help us build your profile.
Profile Main Text*
This information will appear on the front page of your profile and will be the first thing potential customers see. This is a good place to type a description of your business, mission statement, etc. Please provide us with a min. of 2 and a max. of 4 paragraphs.

Address Listed
Do you want your business address posted on your profile?

 Yes
No
Google Map
Do you want a link to Google Maps on your profile so potential customers can find your business easily?

Yes
No
Directions
If you would like to provide written directions to your business from certain roads or areas, please do so here.
Optional Button #1 Title
In this field type the name of your first optional page (e.g. catering, services, menu, etc.) This is a great place to highlight a special service, product, menu, price list, event, etc.

Optional Page #1 Text
Please enter the text you would like to appear when the above button is clicked. Please include a min. of 2 paragraphs and a max. of 4.
Optional Page #2 Title
Please enter the name of your second optional button here (e.g. catering, services, menu, etc.).
Optional Page #2 Text
Please enter the text you would like to appear when the above button is clicked. Please include a min. of 2 paragraphs and a max. of 4.
Testimonials
If you have testimonials from past clients or customers that you would like posted on your profile, enter this information here. Please include at least a first name, city, and state for each testimonial.



Green Card Discount, Reward, or Special
In order to be a part of the Brandywine A-List, you must provide a discount, reward, or special for customers who present their Green Card at your business when they make a purchase. Your offer may be changed at any time. Please enter this information below.
Your Offer