The name of your business as you'd like it listed in the residential listings and in the business directory.
Your number, the usual format.
If you are a bricks and mortar operation, put in your physical address, if you operate without a public storefront, put in your PO Box number.
What category of the Business Directory should you be listed under. See our online directory for reference. Choose one that doesn't exist at your peril.
We'd like your email address, if you don't have one fake it.