Membership Application

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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