New Member Form
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What is the Legal Name of your company (the name registered with the State)? *
What is the Brand Name or Marketing Name (the DBA, if any) of your business?
* If you are a licensed business, what is your License Number?
What is your company Website Address? *
What City is your business located? *
What is your Street Address? *
What is the First Name of the Contact Person for your business? *
What is the Last Name of the Contact Person for your business? *
What is the Role / Title of the Contact Person for your Business? *
What is the Best Phone Number for the contact person? *
What is the Email Address for the contact person? *
How many Employees work for your business? *
What does your Business do? *
Required
(Optional) What are the company Social Media Profiles: Instagram, Facebook, LinkedIn, Twitter, etc?
What Membership Level do you choose? *
What is your Credit Card information: Name on the Card, Card Number, Expiration Date, and 3 Digit Code? *
Are you interested in joining our Membership Directory, where we share your contact information with other members who might be looking for your business? *
(Optional) Are you interested in joining our Discount Directory, where we share your business with other members to entice them to try your offer? If Yes, please note the amount of the discount and the product or service you would like to offer (ex: 20% off all legal services, or 20% off all products)
(Optional) Is there anything we can do to help your business?
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