Directory Input/update Form

Directory Input/Update Form for Where to Go for Small Business Information in Memphis and Shelby County Thank you for deciding to submit or update a directory listing for your agency. If you are correcting information, please list your agency name as it appears in the directory, and complete those categories where changes are necessary.

Name of Agency: *

Please include the full, official name of your agency. Also list any other names by which your agency may be known. For example, the University of Memphis is also known as MSU or Memphis State University.

Purpose:

Please describe the purpose of your organization.

Address:

Enter the agency's address, including zip code. Also, please enter any branches or alternate addresses for your agency.

Telephone:

If an agency has more than one phone number, please indicate which one is the primary number. Is there an answering machine/service? Indicate if phone hours differ from regular business hours. If you would prefer that your fax number or e-mail address not be shared on the public database, please indicate this.

Fax Number:

Email:

TDD/TTY:

Website:

Days open:

Hours open:

Director:

Contact person:

Please list person to contact for each service, or the directors of specific programs or services within the agency.

Eligibility:

Please indicate eligibility criteria (e.g., age, residency, income) for each service.

Fees:

These are any charges or costs to be expected for service(s).

Services:

Please list each service with enough detail that appropriate referrals can be made.

Publications:

Please list any publications of your agency.

Additional information:

Please include any information that will help to explain further your agency's service.

Name of person submitting this information: *

Telephone number of person submitting this information: *

Directory Input/update Form

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