Diverse Business Self-Identification Form

The Berwyn Development Corporation maintains a list of all Berwyn businesses as a resource for the community. It is our desire to celebrate and promote Black-owned, Latinx-owned, woman-owned, veteran-owned, and LGBTQ+-owned businesses by listing them as such.

Please take a few minutes to fill out this form to designate your business as a diversely-owned business, and to give us consent to list and promote your business as such.

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Please reach out to us with any questions or ideas: info@berwyn.net

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* 1. I would like to identify my establishment as a diverse business. (Please select all that apply)

My business is Black-owned.

My business is Latinx-owned.

My business is indigenous-owned.

My business is LGBTQ+-owned.

My business is persons with disability-owned.

My business is veteran-owned.

My business is woman-owned.

I prefer not to be identified publicly.

Other (please specify)

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* 2. Please share your contact information.

Your Name

Company Name

Company Address

Social Media

Website

Phone Number

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* 3. Please share any special offers or promotions you are providing your clients at this time. (Optional)

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* 4. Do you consent to be listed as a diverse business?

I consent to be publicly identified and listed as a diverse business in the City of Berwyn.

I prefer to have my business listed without category.