Submit an Application

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Please fill out this questionnaire, and submit the form using the button at the end of this page. Upon receipt of all the requested documentation, a BBB representative will contact you to discuss Accredited Business standards and fees.

 

In compliance with the BBB Privacy Policy, the BBB of Metropolitan New York will use the personal information you provide below only for the purposes for which you have given permission.
   
Firm Name:
Firm Address:
City:
State:    Zip Code:
   
Mailing Address: (if different)
Address:
City:
  State:   Zip Code:
Public Phone:
Private Phone:
Fax:
  E-mail:
   

Please list three executives of the firm (Mr./Ms. First, MI, Last)

1:    Title:
2:   Title:
3:   Title:

Executive Responsible for BBB Accreditation:

Name:
Title:
Phone #:
  Fax #:

Complaint Handler or person to whom any complaint should be directed (Mr./Ms. First, MI, Last):

Name:
Title:
Phone #:
  Fax #:
Established:  Year:   State:
Incorporated:  Year:   State:
Length of Time at Current Location:

Primary Business Classification (Same as Yellow Pages):


Brief factual description of product or service:


Total Number of employees:
Are you a Franchise?


Does your business require licensing? If yes, complete the following:

Agency Name:
License #:
Date Issued:
Date Expires:
Agency Name:
License #:
Date Issued:
   Date Expires:

Method of Advertising:


Advertising Review: Please note that your application will not be complete until we receive samples of all your advertising, promotional materials, and contracts, used with your customers. Please send this information to the appropriate office.

For businesses in Manhattan, Brooklyn, Queens, Staten Island and the Bronx contact:

BBB Business Development and Relationships Department
257 Park Avenue South
New York, NY 10010-7384

For businesses located in Nassau or Suffolk counties contact:

BBB Business Development and Relationships Department
399 Conklin Street
Suite 300
Farmingdale, NY 11735

For businesses located in Westchester, Putnam, Orange, Ulster, Sullivan and Rockland counties contact:

BBB Business Development and Relationships Department
150 White Plains Road Suite 107
Tarrytown, NY 10591-5521

Why did you decide to seek Accreditation by the Better Business Bureau?

(Choose only one based on most important)

Other:

Please list three business references:

Name:
Company:
Address:
Phone:
   
Name:
Company:
Address:
Phone:
   
Name:
Company:
Address:
Phone:
   

The information on this application was provided by:

Name:
Title:
Phone: