Please fill in the form to register as a contractor on our website.

Thank you for your interest in LIHome411.com, the newest lead source for contractors on Long Island. 

Please provide us some information about your business below and we will contact you quickly.

Name of Your Company:
Owner`s Name(s):
Contact Name, if different:
Your Company`s Address:
Address 1:
Address 2:
City:
State:
Zip:
Phone No.:
? Email Address:
Which is the best way to contact you?:
When?:
Do you have a website:	yes no
If yes, address?:
How long has your company been in business?:
What services do you provide?:
License Number:
Choose a category:	Select oneFlooring - CarpetingGeneral ContractorsHandymanInterior MaintenanceInterior Renovation - DesignMasonry ContractorsExterior MaintenanceExterior Renovation - DesignProfessional Services - Other
Choose a sub category:	Choose the category
Corporate Entity (Sole Proprietor, S Corp, LLC, C  Corp):
Has your Company ever had a different name?:	yes no
If yes, why? And when?:
Does your Company have liability insurance?:	yes no
Does your Company have workers comp  insurance?:	yes no
Does your Company use sub-contractors?:	yes no
Optional:
May we contact referrals/previous Clients:
Referral 1:
Name:
Phone:
Address:
Referral 2:
Name:
Phone:
Address:
Referral 3:
Name:
Phone:
Address:

If you have any questions, please contact us at 516-558-0760.

Thank you again for your interest, and we look forward to talking with you.

Sincerely,

LI Home 411 Inc.