Business Partners Application



Become a Greenlights Business Partner

Thank you for your interest in supporting Central Texas nonprofits through our Business Partners Program!

Please note that submission of the Business Partner application does not guarantee acceptance into the program. Businesses that provide services or products that directly compete with Greenlights’ services and products may not be accepted into the program.

A Greenlights representative will contact you within two weeks of receipt of your completed application to confirm the details of your participation. You will not be charged any fees until your participation as a Business Partner has been approved. If you have any questions about the Business Partners Program or this application, please contact Kate Smallwood at kates@greenlights.org or 512-477-5955 x247.

* Denotes Required Fields

Partner Information
Company Name *
Please provide the name of your company.
Address *
Please add your address
City *
Please add your city
State
Please Select a State
Zip Code *
Please add your zip code
First Name *
Please add your first name
Last Name *
Please add your last name
Job Title
Please provide your job title
Phone Number
Please provide a valid U.S. Phone number with an area code
Email *
Please add a valid email

Credit Card Information
First Name *
Please add a first name for the credit card
Last Name *
Please add a last name for the credit card
Card Type *
Choose a credit card type
Card Number *
Please add your credit card number in the correct format.
Expiration Date *
Add your credit card expiration date
Year *
Please select a year for your credit card expiration
Security Code *
Please add your credit card security code
Company Description (35 Words or Fewer) *
Please type a description of your organization (approx. 35 words or fewer)
Description of Services / Discounts Offered (35 Words or fewer)
Please enter a description of services or discount (35 words or fewer)

Please List 3 References

Reference 1

 Contact Name
Please enter a name.		 Email
Please enter an email.
Phone
Please enter a phone number.		      

Reference 2

 Contact Name
Please enter a name.		 Email
Please enter an email.
Phone
Please enter a phone number.		      

Reference 3

 Contact Name
Please enter a name.		 Email
Please enter an email.
Phone
Please enter a phone number.		      
Invalid Input