CAPE ANN BUSINESS ALLIANCE - Membership Application

Date of Application

YYYY

Name

First Name

Last Name

Business Name

Message

Phone

(###)

###

####

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Describe product or service you wish to become a member under (be specific)

Experience in your field or occupation

Information Licenses

References (name 3)

Years in Business

How long have you been representing/with this company?

Are you able to commit to make weekly meetings on time and stay for 75 min?

The membership fees are $225.00 per year and are NON-REFUNDABLE. A check is to be made out to ‘Cape Ann Business Alliance’ and will be collected by the treasurer.