Indie Business Network ENTREPRENEUR MEMBER Application (US)

IMPORTANT: This IBN Membership Application Form is for US members only.
Canadian members, use this application.

Name*
First Last
Please share the name of the primary owner of the business. If the business is co-owed by two or more people, please include one name and contact us to update the directory with complete information once membership has been processed.
Co-owner
Use this field to add the name of the co-owner if the business is owned by more than one person.
How did you hear about Indie Business?
Business Name*
Phone*
Cell Phone*
Email Address (will not be shared publicly)*
Enter Email Confirm Email
Address (will not be shared publicly)*
Street Address Address Line 2 City State Zip Code
Website URL (skip if you do not have one)

This makes it easier for us to promote your business.
Company Description*
Your Blog Address (skip if you do not have one)

This makes it easier for us to promote your business.
Your Facebook Business Page (skip if you do not have one)

This makes it easier for us to promote your business.
Your Pinterest Page (skip if you do not have one)

This makes it easier for us to promote your business.
Your Instagram Page (skip if you do not have one)

This makes it easier for us to promote your business.
Your Tiktok Page (skip if you do not have one)

This makes it easier for us to promote your business.
Tell us your birthday*
MM slash DD slash YYYY
Promotion Consent*
From time to time, we promote both IBN and our members on IBN's social media accounts, thus expanding our collective sphere of influence and giving more people access to your brand. To do this, we may re-post videos and photos shared on your business-branded social media accounts to IBN's social media accounts. We always tag you, of course, and include copy that drives new customers to your profile or site. We may also use any content you share that discusses your experience with IBN or IBN-related products. This exposes your product line to thousands of potential customers who may not otherwise ever know about your brand!
- Yes, please! I would LOVE for IBN to help market my business through social media!
- No, thank you. I would not like IBN to promote my business on social media.
Any special requests?
Now that you are an Indie Business Network® member, we want to know what we can do right now, in this moment, to make your day even more special. What's your special request? We'll get right on it!
Please click the "YES, I agree" to acknowledging consent to storing and using your personal information to become an Indie Business member and get in touch with you.*
Indie Business will send or share the data on this form with InfusionSoft.
- Yes, I agree
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