SECURE A BUSINESS TODAYPlease enable JavaScript in your browser to complete this form.What is the business or organization you are looking to secure? *Auto DealerSmall BusinessChurchNon-Profit OrganizationPublic SchoolRV DealerRental PropertyOtherWho is the point of contact at the business or organization? *What is the Industry? *What is the legal name of the business or organization? *What is the address of the business or organization? *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhat is the business or organization phone number? *What is the business or organization email address? *EmailConfirm EmailHow did you secure this business or organization? *In person meeting overview of the opportunityZoom meeting overview of the opportunityFull Name of the person securing the location? *FirstLastWhat is your Company Code? *What is your Phone Number? *What is your Email Address? *EmailConfirm EmailCorporate Acknowledgement *The business or organization acknowledges that MySpeedyX® will donate a percentage from each membership referred by the business or organization. Money donated will go towards our NLH initiative that helps provide FREE education to kids in low-income communities and kids in third world countries.The business or organization acknowledges that MySpeedyX® LLC will provide reports on all donations processedBy clicking the box, I certify that I have provided an overview of the association opportunity on behalf of MySpeedyX, LLC, as a certified Authorized Partner.Submit
