Directory Input 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.
Mail this form to: Business & Science Department,
Memphis Public Library &
Information Center
3030 Poplar Ave.
Memphis, TN 38111
or fax this form to: 901-323-7108
Name: ________________________________________________
________________________________________________
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 know as MSU or Memphis State University.
Address: ________________________________________________
________________________________________________
________________________________________________
Enter the agency's address, including zip code. Also, please enter any
branches or alternate addresses for your agency.
Telephone: ________________________________________________
________________________________________________
________________________________________________
If the 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 a public
database, please indicate this.
Fax Number: ________________________________________________
E-mail: ________________________________________________
TDD/TTY: ________________________________________________
Web Site: ________________________________________________
Days Open: ________________________________________________
Hours Open: ________________________________________________
Director: ________________________________________________
Please show the agency's director, etc., along with his/her title.
Contact Person: ________________________________________________
________________________________________________
________________________________________________
Please list person to contact for each service, or the director of
specific programs or services within the agency.
Purpose: ________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Describe the purpose of your organization.
Eligibility: ________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Please indicate eligibility criteria (e.g., age, residency, income) for
each service.
Fees: ________________________________________________
________________________________________________
________________________________________________
These are any charges or costs to be expected for services(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 (if different
from the agency's general number.
________________________________________________
Date: ________________________________________________