Membership Application Form

Association and Member Objectives:

  • Promote ethical business practices in the community
  • Generate business by referral leads and direct business
  • Discuss and analyse forces and trends affecting members
  • Participate in co-operative advertising ventures
  • Build fellowship and friendship between members through lunches, discussion, social events, trade talks, etc.
  • Grow through encouraging new memberships
  • Assist members with promoting their business

Please complete the following application form.

Note: All fields are mandatory. If you are unable to supply a response, please enter N/A.

 
Name:  
Sponsor:

A sponsor is a member of Professional Business Associates that has recommended you for membership.

Sponsorship is not required to become a member, but we like to show our appreciation to members for recruiting new members.
Business Name:  
Business Phone:  
Business Address:  


Position/Title:  
Business Associate:

A business associate is someone who is designated by you to attend meetings, in your absence, up to 25% of the time.
How long has this business been operating?  
Home Address:  


Home Phone:  
Business References:

Business references are an integral part of your membership application.

Professional Business Associates wants to ensure that every member is well respected in the business community.

The references you supply will be contacted in order to verify your reputation.

 
#1 Name:  
Phone:  
#2 Name:  
Phone:  
E-mail Address:  
Do you belong to another leads club?   Yes    No
Spouse's Name:  
Spouse's Occupation:  
Major Business Services or Products:  
Secondary Business Activities:  
Hobbies and Interests:  
What do you expect to get from joining the association?  

All applications are subject to review by the Executive Committee of the association,
using criteria approved by the general membership.

If approved, a membership fee, along with the quarterly dues prorated,
will be due and payable at the new member’s first meeting.

Submit your application by pressing the button below.
 
Please enter the text in the following image: