Membership Application

Mail the application with membership dues to the above address.

        

 

FULL NAME:  ________________________________          __________________________________

HOME ADDRESS:____________________________________________________________________

                                ____________________________________________________________________

BUSINESS NAME:____________________________________________________________________

BUSINESS ADDRESS  ________________________________________________________________

PHONE (DAY) ________________________ PHONE (EVES) ________________________________

EMAIL ______________________________WEBSITE: _____________________________________

YEARS IN BUSINESS __________ TYPE OF BUSINESS___________________________________

 

I/ We hereby apply for active membership of Fort Gratiot Business Association, and agree, if accepted, to conform to Association by-laws and rules.

 

Annual Dues:            $100.00 for new members   /   $100.00 for renewing members

Make check payable to:  Fort Gratiot Business Association.

 

Referring Member: ______________________________________

 

 

__________________________________   ________________________________    _____________

Print Name                                                     Applicant Signature                                    Date

   

_________________________________    ________________________________    _____________

Print Name                                                   Partner/Spouse/Manager Signature             Date

                               APPLICANT                                                                                                                 SPOUSE / PARTNER/  MANAGER                                                                 

www.fortgratiotba.org

Email: info@fortgratiotba.org