Schedule Appointment with Black Business Clique

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First Name *

Last Name *

Phone

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
Black Business Directory	x $10.00	$10.00 per month
Total: $10.00

Black Business Clique LLC has authorization to use my business name, logo and slogan for marketing and advertising purposes. I understand that payment will be automatically be debited from my account monthly until I cancel my subscription.

***Once payment has been made, please email or DM Black Business Clique with your Name, Business Name, Social Media handle (example @BlackBusinessClique).***

Thank you