New Member Application

Please fill out the following form completely. Join online immediately with credit card:

* Indicates the field is required.

Business Name *
Doing Business As
Employees (FTE)
Main Category

Create Your Username and Password Below
This will enable you to take advantage of member benefits.

Salutation
First Name *
Middle Initial
Last Name *
Annotation
Preferred Name
Title
Web Username *
Web Password *

Enter your Mailing Address

Mailing Address:

Address - LN1 *
Address - LN2
City *
County
State *
ZIP *

Street Address (Complete only if different from mailing address)

Street Address: (Complete only if different from mailing address)

Address - LN1
Address - LN2
City
County
State
ZIP

Phone *

Phone 2

Fax

E-mail Address *

Web Site Address

I understand that by providing my mailing address, email address, telephone number, and fax number, I consent to receive communications sent by or on behalf of The Business Council via regular mail, email, telephone, or fax.

New Membership Investment

Enter your annual dues amount based on the below investment schedule

TOTAL :

Number of full-time equivalent employees (Full & part time)
1-5 employees	$325	includes one main and one secondary representative
6-10	$410	includes one main and two secondary representative
11-25	$515	includes one main and three secondary representative
26-50	$705	includes one main and four secondary representative
51-75	$880	includes one main and five secondary representative
76-100	$1,060	includes one main and six secondary representative
Over 100	$325 + $7.50/employee includes one main and one secondary representative

Add $30 processing fee for each new
membership will be added at checkout .

*Main and secondary representatives
are listed in the online directory