Become a Merchant Partner (Monthly Form) Become a Merchant Partner (Monthly) Business Name(Required) Name Contact Name(Required) First Last Business Owner's NameIf the Contact Name is not the business owner, please provide the business owner's name here. First Last Contact Email(Required) Enter Email Confirm Email Contact PhoneBusiness Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Mailing Address Same as above Mailing Address, if different Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Renewing My Partnership for 2025(Required) Yes No Social Media PostsIn the next two fields, please select your top 5 months for your business to be featured on Brunswick Main Street's social media sites. We will do our best to honor your first 3 choices, but we want to limit the number of businesses per month to 4. Businesses that are highlighted each month will be based on a first-come first-served basis.Preferred Months for Social Media Posts(Required)Please select your top 3 months for your business to be featured on Brunswick Main Street's social media sites. January February March April May June July August September October November December Alternate Months for Social Media Posts(Required)Please select 2 alternate months for your business to be featured on Brunswick Main Street's social media sites. January February March April May June July August September October November December Monthly NewsletterWe will feature businesses each month in our monthly newsletter. Please indicate a preferred and alternate month you would like us to feature your business in the following fields. We want to keep these to no more than 2 a month so please understand that you may not get your first choice.Preferred Month for Newsletter Feature(Required)Please select the month you would like your business to be featured. January February March April May June July August September October November December Alternate Month for Newsletter Feature(Required)Please select an alternate month you would like your business to be featured. January February March April May June July August September October November December New T-Mobile Town KioskWe are going to feature businesses each quarter in our T-Mobile Kiosk located at Square Corner Park. Please indicate your preferred and an alternate quarter you would like us to feature your business below.Preferred Quarter for Kiosk(Required)Please select the quarter you would like your business to be featured in the Square Corner Park kiosk. January-March April-June July-September October-December Alternate Quarter for Kiosk(Required)Please select an alternate quarter you would like your business to be featured in the Square Corner Park kiosk. January-March April-June July-September October-December Merchant Partner Fee(Required)Thank you for your support! Every dollar counts to help Main Street on its mission to support downtown business owners, stimulate downtown economic growth, promote our unique cultural & recreational assets, and beautify & celebrate the heart of our city. You agree to pay the Merchant Partner fee at a rate of $21 charged monthly. Price: Total Δ