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* 1. Name of business or community organisation

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* 2. Please select one option which best describes your activity

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* 3. Areas covered? - Select from list

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* 4. Street Address

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* 5. Address line 2

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* 6. City / Town / Village

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* 7. Post Code

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* 8. Telephone:

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* 9. Display my telephone number:
(selecting "No" means number will not be shown in the online or print directories)

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* 10. email address

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* 11. Contact name
Optional - this will not be shared and only used for maintaining and promoting the EBI directory directly with contacts.

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* 12. Short description of what the business / community org. does:

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* 13. Website (http....)

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* 14. Facebook (http....)

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* 15. Twitter (http....)

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* 16. Instagram or other (http....)

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