Membership Application Form


Business Name: *
Mailing Address:
City:
Postal Code:
Business Location:
Hours of Operation:
Phone: *
Fax:
Email:
Website:
Contact Person: *
Owner:
Product/Services Provided:
# of Employees: *
Membership Fee: *
GST: *
Total: *
Please invoice:

Fee Structure (Part Time employee=1/2 employee)

# of Employees

Annual Fee

GST

Total

1 - 5 161.00 8.05 169.05
6 - 10 229.00 11.45 240.45
11 - 20 301.00 15.05 316.05
21 - 60 399.00 19.95 418.95
61-100 518.00 25.90 543.90
101-300 710.00 35.50 745.50
301-500 1,226.00 61.30 1287.30
501-1000 1,620.00 81.00 1701.00
Non-Profit 91.00 4.55 95.55
Individual 91.00 4.55 95.55


Please check if you are intrested in participating on:

Board of Directors
Political Action Committee

Membership Relations Committee


How would you like to receive your newsletter?

Please list all email addresses for persons you would like to receive the newsletter


 

 
 

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