For Our Residents
For Our Visitors
*Name of the Business:
*Category:
If other category:
*Street:
Suite:
*City:
see note below
*Zip Code:
*Phone Number: ( )
Toll-Free Phone Number: ( )
E-mail Address:
URL (Your Business
Home Page Address):
NOTE: A $120.00 yearly Listing fee will be charged to Businesses outside of Leavenworth County. The Listing Fee includes your company name, address, phone number as well as a link to your Web site, if applicable.

If you are a business outside of Leavenworth County and would like to include your listing on Leavenworth-Net, please complete this form.
A representative from Leavenworth-net.com will contact you within 5 business days.
For a small monthly fee we can include a Company Profile about your business. If you check "Yes", a representative from Leavenworth-net.com
will promptly contact you.
Would you like us to create a Company Profile for your your business? No Yes
Point of Contact:
FOR OUR INFORMATION ONLY
*First Name:
*Last Name:
*Phone Number: ( )

Remarks (if any):
These comments will not be published with your listing.
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