Partner Questionnaire - Texas Home Talk

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Applicant Contact Information: Full Name

First

Last

Applicant Contact Information: Business Name

Applicant Contact Information: Email Address

Applicant Contact Information: Phone Number

Applicant Contact Information: Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Community Presence and Professional Licensing: Are you locally owned and operated? (Yes/No)

Community Presence and Professional Licensing: How many years have you served the local community?

Community Presence and Professional Licensing: Do you hold active professional licensing/registration?

Community Presence and Professional Licensing: If licensed/registered, list license type(s) and number(s)

Community Presence and Professional Licensing: Upload a headshot (file upload)

Drag & Drop Files, Choose Files to Upload

Online Reputation and Reviews: Business website URL

Online Reputation and Reviews: Links to review profiles (Google, Yelp, Facebook, etc.)

Online Reputation and Reviews: Are you willing to request reviews from customers as part of your presence in the advertising network? (Yes/No)

Online Reputation and Reviews: Briefly describe how you handle customer feedback and reviews

Business Conduct and Community Involvement: Do you agree to uphold professional conduct when representing the local business advertising network? (Yes/No)

Signature conduct (Yes/No)

Business Conduct and Community Involvement: Have you been subject to any disciplinary action, suspension, or unresolved complaints in the past 5 years? (Yes/No)

Business Conduct and Community Involvement: If yes, please explain

Business Conduct and Community Involvement: Describe your community involvement (events, sponsorships, volunteering, local partnerships)

Network and Co-Marketing Commitment: Are you willing to participate in co-marketing with the local business advertising network? (Yes/No)

Network and Co-Marketing Commitment: Preferred co-marketing activities (select one)

Network and Co-Marketing Commitment: If 'Other', describe your preferred co-marketing commitment

Network and Co-Marketing Commitment: Can you respond to network requests within 2 business days? (Yes/No)

Final Open Questions and Declaration: Why do you want to join the local business advertising network?

Final Open Questions and Declaration: What unique value will your business bring to the community presence and professional network?

Final Open Questions and Declaration: Declaration and Agreement (checkbox agreement)

I confirm the information provided is accurate, and I agree to participate in the local business advertising network in good faith.

Final Open Questions and Declaration: Digital Signature

Clear Signature

Final Open Questions and Declaration: Signature Date