LHF Business Directory Application

Name of Business Owner

First Name

Last Name

Owner Contact Phone

( for LHF Office use )

(###)

###

####

Owner Contact Email

( for LHF Office use )

Name of Business

Business Phone Number

(###)

###

####

Business Contact Email

Business Website ( if applicable )

http://

Business Address ( if applicable )

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Social Media ( if applicable )

Brief description of your services