Fill out the form below to start your application with Amazon Hub Delivery. Please note: This form is for registered businesses only.
First Name *
Last Name *
Email Address * Please use an email address that you will have access to for the duration of your application
Phone Number *
Legal Business Name * Legal Business Name or DBA
Business Street Address *
City * City where your business is located
State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY State where your business is located
Zip Code * Zip code where your business is located
How did you hear about us? * Amazon Representative Visit Referral Chamber of Commerce or Local Oganization Local Event Google Facebook Postcard Newspaper Ad Radio Ad Email Instagram LinkedIn Mobile Ad Nextdoor App Door hanger Outdoor Billboard iHeart Streaming/Broadcast TV Reddit Select an answer choice from the list
Referral First Name The first name of the person who referred you.
Referral Last Name The last name of the person who referred you.
Referral Email The email address of the person / Chamber who referred you.
Sales Assistant * The name of the Amazon Representative that helped you.
Are you the owner of this business? * Yes, full owner Yes, part owner No, but I have consent from the owner No
Owner First and Last Name *
Owner Personal Email * The email address of the owner of the business.
Tell us more about your business * Appliance Store Auto Bakery Bicycle Shop Butcher Car Dealer Carpentry Chemist Clothing Coffee Shop Convenience Store Distribution Driving School Dry Cleaners Electronic Shop Fitness Center Florist Food Delivery Food - Fishmongers Gambling Gas Station General Store Giftshop Grocery Gym / Personal Trainer Haberdashery Hair & Beauty Hardware Store Health - Herbalist Home Furnishing Hospitality Hub DP Only Logistics / Transportation Company Milk Shop Music Shop Newspaper Online Business Personal care - Tattoo/Piercing Pet Shop Photo Store Posting Service Property Management Recycle / Repair Restaurant Retail / Food Retail / Other Retail / Service Rice Store Salon Salon / Barber Shop Specialty Retailers Sports Store Staffing Service Telecom Travel Agent Vape & Tobacco Other
How long has your business been actively operating? * Not yet in business Less than 90 days 3-12 months 1-5 years 5+ years
What type of business location do you currently operate from? * Storefront Home
Preferred Language * Arabic Chinese English French German Hindi Italian Japanese Korean Portugese Russian Spanish Tagalog Turkish Urdu Vietnamese
Comments
By submitting this form I hereby acknowledge that the information collected on this intake form is true, accurate, and will be used in the application process to become an Amazon Hub Partner. If the information I provide is not true and accurate, I understand that Amazon may no longer consider my company for Hub Delivery.