Thames Centre - Support Local

To have your business included in the next edition of the Support Local Brochure that will be printed and widely distributed, please submit your interest below. Electronic versions of the brochure will be updated regularly, whereas paper copies may be every 6-12 months.

Business Name:

Description of Products/Services:

Please provide promotional wording for your business (taglines, etc.)

Please provide a brief biography of your business (when established, etc.)

Contact Name:

Phone:

Email Address

Business Address:

I understand that information on this page will be made public and used for promotional material.

Do you want your phone number/email to be made public and used for promotional material?

Do you want your address to be made public on the promotional material map?

Can the municipality use your phone number and email address to contact you for any reason regarding this program?

Signature

Please make a best effort to use your mouse or finger (in the case of a cell phone or tablet), to sign this box.

Personal information contained on this form is collected pursuant to the Freedom of Information and Protection of Privacy Act/Municipal Freedom of Information and Protection of Privacy Act and will only be used for the purpose of its collection. Questions should be directed to the Freedom of Information and Privacy Co-ordinator at the institution where the request is made.