Membership Application Thank you for your interest in becoming a member of SBBI. Please fill out the membership application below for consideration by the SBBI Board. Date* MM slash DD slash YYYY Name* First Last Email* Company* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone/Work*Phone/CellMembership Category Applying For* Referred By Description of Your Business*Length of time in business* What contributions will your membership bring to SBBI?*Please list any groups (e.g. civic, business, networking, etc.) that your have or still belong to. Please indicate which ones you are still active in.*What benefits do/did you receive from being a member of the groups you listed above.*Are you willing to commit yourself to becoming an active member of SBBI through attendance, participation and referrals?* Yes No Do you have a secondary business?* Yes No Please describe your secondary business.Do you have any conflicts with your current business relationships that may inhibit you from giving referrals to SBBI Members?* Yes No Please provide any additional information about yourself and your business which you would like to include.Birth MONTH and DAY only We like to recognize our members during the month of their birthday. Please enter the MONTH and DAY only in the field above. i.e. October 19By clicking the "Submit" button below, I indicate that I understand that an open category does not guarantee automatic acceptance. I also agree to pay the $100 deposit to the SBBI Treasurer at the next meeting I attend. I understand that the deposit will be returned to me if I am not approved as a new member. I also understand that if I choose to resign from the group or if my membership is terminated in accordance with the current Bylaws, before the period of one year, I will forfeit the deposit. Option to be refunded on a case by case basis during the first year at the discretion of the Board. I further understand that if I stay beyond the period of one year, the amount of the deposit will be applied towards my dues.* I agree PhoneThis field is for validation purposes and should be left unchanged. Δ