New Member Information

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I certify that the following information is true and complete and I will provide confirmation if required. You may use any source for information related to his application and each source is authorized to provide you with is confidential information.If requested, you are authorized to provide credit information to other credit grantors, consumer reporting agencies and credit bureaus.

Additional Information

Annual Dues are $750.00. These dues cover meals at the biweekly Member Lunches as well as marketing and operational costs of the club.

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Date
*

YYYY

Primary Member Name
*

Company Name
*

Classification
*

Address
*

Phone Number
*

Email Address
*

Alternate Member Name

Sponsor #1
*

Sponsor #2
*

Have you been instructed about club policies by the sponsors? *

Yes

How long has your company been established? *

Have you ever been a member of the St. Catharines Business Club? *

Yes

Are you associated with any other business club? If yes, which one?
*

List products/services performed: *

Please provide three (3) trade references: *

Please enter your name below.
*

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