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BIG VALLEY AREA BUSINESS ASSOCIATION
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APPLICATION FOR MEMBERSHIP
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DATE____________-______ NAME OF BUSINESS_____________________________________________________ PHYSICAL ADDRESS OF BUSINESS__________________________________________________ MAILING ADDRESS OF BUSINESS___________________________________________________ CITY______________________________________ STATE____________ ZIP_____________ CONTACT PERSON_____________________________________________________________ EMAIL ADDRESS_______________________________________________________________ CELL PHONE#______________________________BUSINESS PHONE#____________________ HOME PHONE#_____________________________FAX#_______________________________ Information above will be placed on our web site at www.visitbigvalley.com If you wish to withhold any of the above information, Please make a note of what you want withheld. IN BRIEF, DESCRIBE TYPE OF BUSINESS_____________________________________________ ___________________________________________________________________________ PLEASE ENCLOSE A CHECK IN THE AMOUNT OF $65.00 THIS IS A ONE TIME FEE. MEMBERSHIP DUES WILL BE BILLED AT $50.00 PER YEAR OR AS DESIGNATED BY THE BOARD OF DIRECTORS. DUES WILL START IN FEBRUARY AFTER YOU HAVE BEEN A MEMBER ONE FULL YEAR. THE PRESENT COORDINATOR IS NANCY KAUFFMAN HAVE QUESTIONS? WRITE TO ABOVE ADDRESS PHONE: 717-935-9965 |
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