Apply for Membership Name First Last Name of Business*Please enter the name of your shop, boutique or business.Are you a locally or independently owned business?*YesNoBusiness Address*Your business must be in Old Town Alexandria, VA to be eligible for membership. Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone*Business Email* Business Website Business Hours*How many years have you been in business?*1-3 years3-5 yearsOver 5 YearsMarketing Programs*Are you using any marketing programs currently? Check all that apply. Email Marketing (Newsletters) Direct Mail Marketing (Paper mail) Social Media Marketing (Facebook, Twitter, etc.) Website or Blog None Social Media EngagementWhat social media channels does your business use to engage with customers? Facebook Twitter Pinterest Foursquare Instagram Google+ LinkedIn Yelp Event HistoryWhat type of events (promotional or otherwise) have you held at your store? Why do you want to join the OTBD?*PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.