BMD Producer & Seller Profile Application Form

"*" indicates required fields

Company/Organization Name*

For Internal Use...

First Name*

Last Name*

Your Title*

Email Address*

Are you authorized to submit this application*

We will contact you...

Is the company or organization registered with SDAT to do business in Maryland*

You may continue if you would like for us to contact you...

For Internal Use, Contact Person's Info if Different…

First Name (If Different)

Last Name (If Different)

Title (If Different)

Email Address (If Different)

Phone Number

Contact Person's…

Address Line 1*

Address Line 2 (If Applicable)

Address Line 3 (If Applicable)

Town or City*

State*

Zip Code*

For Directory Listing & Promotions (If different, complete all that apply)

Company's/Organization's Phone Number

Company's/Organization's Email Address

Address Line 1

Address Line 2 (If Applicable)

Address Line 3 (If Applicable)

Town or City*

State*

Zip Code*

Website Address URL

Shopping Information URL*

Ecommerce URL (If Different)

Facebook Page

Instagram Page

LinkedIn Page

X Page

Pinterest Page

YouTube

Briefly describe your business/organization and the Maryland-made consumer products that you make or sell. If you are a business or trade organization that provides a physical sales space or digital sales platform, respond for your organization and about the types of Maryland-made consumer products sold by your members/clients/constituents.*

Our Maryland-made products include (briefly cite types of products in list form)*

Key Words (Up to 100 Words, separating by commas)*

We sell in/on (select all that apply)*

Specify*

We are a (select all that apply)*

Specify*

We make or sell consumer (select all that apply)*

Specify*

We are affiliated with (Select all that apply)*

Specify Main Street*

Main Street Maryland Communities (specify)*

Baltimore City Main Streets (specify)*

Other Affiliation(s) (specify)*

Images

Enter up to three images

Image 1 (Logo preferred)*

Accepted file types: jpg, jpeg, png, Max. file size: 5 MB.

Image 2

Accepted file types: jpg, jpeg, png, Max. file size: 5 MB.

Image 3

Accepted file types: jpg, jpeg, png, Max. file size: 5 MB.