New Member Application

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

Business Name

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

Web Username
Web Password
Salutation
First Name
Last Name
Chapter

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 :

2010

Partnership Investment Schedule

Category		Annual Payment
Business, 1-5 Employees		$265.00
Business, 6-10 Employees		$330.00
Business, 11-20 Employees		$460.00
Business, 21-50 Employees		$530.00
Business, 51-100 Employees		$800.00
Business, 101-300 Employees		$1,300.00
Business, 301-500 Employees		$1,970.00
Business, 501-1000 Employees		$2,375.00
Business, 1001-2000 Employees		$2,965.00
Business, 2001-3500 Employees		$3,405.00
Business, 3501+ Employees		$3,960.00
Charitable/Non-Profit, 1-50 Employees		$180.00
Government, per municipality		$570.00
Home �Based Business		$205.00
The Incubator � (Open to new entity small business, one to five employees, in the first three years of start-up)
First year of Start-up		$135.00
Second year of Start-up		$185.00
Third year of Start-up		$225.00
Fourth year reverts to General Business category

Annual Investment Amount $
Processing Fee (one time non-refundable) $ 35.00
Total Amount $

Investments may be subject to a 4% increase each calendar year.