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MBAT Business Application
Apply now to help coMBAT human trafficking in Mississippi
Take steps to make your community a safer place to work and live.
Business Name
Business Address
Address
Address 2
City/Town
ZIP/Postal Code
Business Website
Business Contact Name
Business Contact Title
Business Contact Email
Business Contact Phone
Business Industry
- Select -
Hospitality
Convenient stores
Agriculture
Janitorial services
Construction
Landscaping
Restaurants
Factories
Salon services
Massage parlors
Retail services
Religious institutions
Child care
Domestic work
Automotive
Other
How did you hear about MBAT?
Applicant understands that participating, or applying to participate, does not create any business relationship between the Mississippi Secretary of State’s Office or any of its employees beyond what is described within the application.
Applicant agrees to join the fight to coMBAT human trafficking in Mississippi by reviewing the resources provided on the MBAT website and sharing all relevant information and trainings with employees and business community. We also encourage participants to create their own best practices.
Certification of Applicant: I certify that I have reviewed the preceding statements and any attached supporting documentation, and to the best of my knowledge, the information provided is true, accurate, and complete. I also certify that I have the authority to execute this application on behalf of the applicant. Reference herein to, or registration by, any specific commercial entities, trade names, trademarks or service marks, or otherwise, does not constitute or imply its endorsement, recommendation, a promise of future employment or work, or favoring by the Mississippi Secretary of State’s Office.
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