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Directory Listing Form Request

To list your business or job on the KaimukiHawaii.com you must become a KaimukiHawaii.com member (NO CHARGE/FREE) This is necessary to legally enable us to have your logo and description on the site with permission. To become a member please fill out our Membership form below. The listings must be in the immediate Kaimuki, Hawaii area. Benefits: 1 Directory Listing, 1 Job Directory Listing, 1 Coupon Text Insert and more. You have nothing to lose and everything to gain with exposure on the KaimukiHawaii.com Web site. Please fill out the membership request form below and press the submit button. You will receive confirmation via email with a confirmation number and related info to finalize your request. Membership Contact Info A * indicates a required field. * First Name * Last Name Title Company * Address * City * State * Zip Country * Phone (include area code) Fax (include area code) * E-mail Address How did you find out Us? Select From The ListEmailFriendInternetDirect MailNetworkingClient ReferralWalk-inFriend/RelativeOther ReferralCold CallFax BroadcastTelevisionMagazineRadioNewspaperOther Source - Please specify Other Source - Please Specify: Directory Listing Details * Directory Listing Type Public/GovernmentBusinessJobNonprofit * Directory Company Name/Title Directory Contact Name * Address * City * State * Zip * Phone (include area code) Fax (include area code) Company URL (Optional) Company Email (Optional) Please use content (i.e. about us, company logo) from my Company URL/Web site above for my profile. I understand I will have option to make changes/updates to my profile. Directory Tagline - Optional) This will go below your title to entice visitors to click on your link. Directory Description (Will show up in Profile Page Description)- Optional Hours of Operation - Optional Coupon Text (Will show up on Profile Page in Coupon Area) - Optional Coupon Expire Date Comments for KaimukiHawaii.com Web Team/Management Kaimuki Business and Professional Association Member?Yes By submitting this request, you acknowledge that above information is true and correct to the best of your knowledge. You also understand that your membership/listing request is subject to approval by KaimukiHawaii.com management and you agree to the KaimukiHawaii.com Member Agreement Terms and conditions. * I agree to Member Agreement Terms & Conditions.   Powered by the MBC/eTrigger

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