Become a Sanctuary:

Application & Agreement

Business Name:

Please provide your legal business name as registered.

Full Legal Name:

As shown on your driver's license.

Preferred Name:

Preferred Pronouns:

He/Him

She/Her

They/Them

Other Pronouns:

Email

Phone

Emergency Contact:

Relation:

Emergency Contact Phone Number:

https://www.sanctuary4all.org/our-mission

My business aligns with the mission and values of Sanctuary for All.

Are you willing to display physical and/or digital Sanctuary for All Signage at your business ?

Yes

No

Do you own a physical business location or a digital business?

Physical Location

Digital Business

If you own a physical location, are you able to offer resources (e.g., a safe waiting area) for individuals seeking sanctuary from potential harm?

Yes

No

Business Address

Business Address (if physical location, otherwise type N/A)

Country/Region

Address

Address - line 2

City

Zip / Postal code

Type of Business

e.g., retail, restaurant, coffee shop, office, etc.

# of Employees?

Do you have any relevant skills or experience that you are willing to contribute to support Sanctuary for All's mission

Sanctuary Business Size and Participation Fee

Small Business Sanctuary (1-10 Employees$399

Small-Medium Business (11-50 employees)$599

Medium Business (51-100 Employees)$799

Large Business (101-500 Employees)$999

Enterprise (501+ Employees)$2999

By checking the box below, you certify that all information provided is accurate and complete to the best of your knowledge. You understand that any false or misleading information may result in termination of your participation as a Sanctuary.

Signature

Date

Month

Day

Year

Apply to Become a Sanctuary

Become a Sanctuary:

Application & Agreement

Business Address