MEMBERSHIP APPLICATION

Interested in joining Rowan Business Alliance? For only $96, you can enjoy all of the benefits of the Alliance. Simply complete the form below and we will invoice you for the membership fee.
 
Company Name:
Contact Name:
Mailing Address:
City (for mailing address):
Street Address:
City (for street address)
Zip:
Phone:
Fax:
Email:
Website:
Ownership:
   
 

If individual, provide full name, present home address and Social Security number of owners:
 
   
  If partnership, list names, home addresses and Social Security numbers of partners:
 
   
  If corporation, list names and home addresses of officers and directors:
 
   
Owner / Manager's Name:
Present Home Address:
City:
Zip:
Home Phone Number:
   
List 3 credit references for your company, including mailing address, phone numbers and account numbers. (Not needed if business has been in operation for more than 2 years.)
   
Type of business: (Please select the appropriate business classification.)
   
Please include a brief description of your primary service, product, etc.
   

Desire membership for:
(check all that apply)

 

* = Requires additional contract
Collection Services*
Monthly Newsletter "Outlook"
Monthly Mortgage Listing
Promotional Activities / Events
Copy and/or Mailing Services
Educational Seminars
Monthly Judgment Listing
Billing Services*
Website Services
Management Services*
Foundation Grants
Consumer Credit Counseling
Holiday Caravan Parade
Credit Reports & Services
Business Alliance Partners Network
Scholarships for Youth
Marketing & Image Development
Other
   
Note: Please answer all applicable questions. Providing complete answers will help prevent unnecessary delays in the processing of your application.
 
MEMBERSHIP DUES ARE $96 PAYABLE ANNUALLY.
 
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