Join Our Network: Business Partner Signup

URL

This field is for validation purposes and should be left unchanged.

Your business

Business name(Required)

Business type(Required)

Website

Needed for Level 2.

City(Required)

State(Required)

Service area

Short description of your business

One or two sentences. If you allow a directory listing, this may be shown publicly once your partner page is ready.

Logo (optional)

Accepted file types: jpg, jpeg, png, webp, Max. file size: 3 MB.

JPG, PNG or WebP, up to 3 MB. Only upload a logo your business owns.

Primary contact

Name(Required)

Role(Required)

Email(Required)

Phone(Required)

Additional contact (optional)

Name

Role

Email

Phone

Payment contact

Payment contact name(Required)

Payment contact email(Required)

Payment contact phone(Required)

Requested participation level

Page address that shows KCPSR(Required)

Signing up joins your business to the network at Level 1 right away. If you choose Level 2, we record your request, and the Level 2 rate ($25 total, replacing the $15) begins once KCPSR has verified its requirements with you. KCPSR will supply your referral code and the $10 customer discount once they are activated; please share them only after that.

How would you prefer to receive referral contributions?

Payee name (business or organization name for payment)(Required)

Checks are mailed to the mailing address in the first section. Please make sure it is complete.

PayPal payment email(Required)

Venmo handle(Required)

Zelle email or mobile phone(Required)

Payment instructions (optional)

This records your payment preference. KCPSR will confirm payment arrangements before the first payout. Do not enter bank account or routing numbers, card numbers, Social Security numbers, passwords or tax documents. Referral contributions are payments for qualifying completed referrals, not tax-deductible donations.