Food Business Promotion Request

Business Name

Type of Business

Supplier about Business

Menu

Describe your menu offering (Afghan, Palestinian, Cafe, Knafeh, etc.)

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

If a restaurant, enter the restaurant’s address.

Business Phone Number

Do not use hyphens, parenthesis, or other special character

Business Email

Is the business Muslim majority owned (51% or greater)?

Your Name

First

Last

Your Title/Responsibility

Owner's Name

First

Last

If more than one owner, enter one (or majority) owner’s name.

Is everything on your menu halal?

To the best of your knowledge, are all your ingredients halal?

Do you use alcohol in your food or sell alcohol?

Halal Meat Supplier

Name your current halal meat supplier. Enter “N/A” if you do not use or sell meat.

How did you hear about SoCal Halal®?

Representative Statement

I am an official representative for the business listed on this form and all the above statements are true and factual to the best of my knowledge. I acknowledge that SoCal Halal® is a registered trademark and all rights are reserved by SoCal Halal® ownership.