Name of Business/Organization/Individual, etc. as it should appear in the Directory *required field

Address of Business/Organization *required field

Website

Industry Type

Union Affiliation (if any)

Geographic Region(s) served by your organization or business:

Brief description of your business or organization

Is your business currently providing products and/or services to any union(s) in the Philadelphia area?
yes no 
If you answered Yes, which unions?

Does your business employ members of a Philadelphia area union?
yes no 
If you answered Yes, which unions?

Your Special Offer(s):
All approved Preferred Partners (in business Categories) are encouraged to offer some type of discount and/or preferred service exclusively to union members/supporters, if at all possible. Please describe the discount/added benefit you will offer (leave blank if not applicable):

Referred by: (Name the union/organization/individual who referred you, if applicable)

How did you hear about PhillyLabor.com?

Full Name Of Contact Person: *required field

Title: *required field

Work Phone Number (add extension if necessary) *required field

Fax Number

Email *required field

Please review your application carefully. By submitting this application, you certify that you are an authorized representative of the organization/business named in this application.